Suggestions for A Program For Health Teaching in the Elementary Schools Health Education No, 10 DEPARTMENT OF THE INTERIOR BUREAU OF EDUCATION 1921 I.MI^Ari«<ij.» Suggestions for a Program for HEALTH TEACHING in the ELEMENTARY SCHOOLS By J. MACE ANDRESS HEAD OF THE DEPARTMENT OF PSYCHOLOGY BOSTON NORMAL SCHOOL and MABEL C. BRAGG ASSISTANT SUPERINTENDENT OF SCHOOLS NEWTON. MASS. Health Education No. 10 DEPARTMENT OF THE INTERIOR BUREAU OF EDUCATION 1921 LIBRARY OF CONGRESS SEP 30 1921 DOCUMEhiTi UiVlSION ^ HEALTHY CHILDREN -AAERICAS PRIDE- HEED THE RULE5 OF M GAME Health poster maJ^ing interests children. The authors acknowledge their great ohligations to the grade teachers who have generously contributed material and who have clearly demonstrated in the schoolroom the practicability of this work. To the participants in the fellow- ship contest of the Child Health Organization of ATnerica, 1920, they express grateful appreciation of the valuable ideas which have been gathered from their theses. CONTENTS. Page, Purpose of this pamphlet 9 I. General Suggestions Relating to Health Education in Every Grade. The goal of health education is healthy children 11 Every child entering school needs a thorough physical and mental exami- nation at school entrance 11 Individual health training through all the grades is vastly more im- portant than any crystallized course of study 12 Weigh and measure school children regularly 12 Report weight to parents each month 13 Associate pleasure with the practice of health habits 14 Utilize opportunities at school to establish health habits 11 Assign a definite amount of time on the school program for health inspec- tion and instruction 15 Enlist cooperation of parents and community 16 The teaching of health should be connected with citizenship 18 Encourage and definitely plan for physical exercises and play in every grade 19 Strive to develop wholesome interests and attitudes in your pupils 20 School physicians are needed 21 School nurses are needed as a connecting link between the home and the school 21 There should be standards for promotion and graduation in health as in any school subject - 22 To be successful in health teaching the teacher needs to exemplify what she teaches 22 Some health teaching every teacher may do 23 A course of study for any grade should be worked out with the coopera- tion of successful health teachers in that grade 24 A good health slogan 24 Special health classes are needed for malnourished children 24 Domestic-science courses should deal definitely with health habits 25 School furniture should be adjustable and adjusted 25 The hygiene of the eye and ear 26 5 CONTENTS. Page. Look after the care of children's teeth in every grade 28 Cooperation among all of those agencies working for the health of chil- dren is imperative 30 II. Moke Specific Suggestions Rei.ating to Health Education in the Geades. Health teaching is habit formation 31 Monotonous repetition must be avoided 32 Approach the work from different angles : 32 The rules of the game 33 Weighing and measuring 34 Daily teaching of health habits 37 Milk luncheon 37 Special health classes 39 An outline for nutrition classes 40 Food classes 43 The physical director 44 The work is planned for three groups, not for each grade 44 Early elementary group 45 Psychology of health teaching in the early elementarj- grades deals with playful spirit 45 The work for the early elementary group 46 The program 46 Rules of the game 46 Weighing and measuring 47 Daily inspection 47 Health material in other school subjects 50 Original rhymes and rhymes based on Mother Goose.. 54 Health rhymes 57 Songs 57 Representations of weight records 60 Vegetable charts 60 Scrapbooks 62 Games 63 Original stories 64 Middle grades (IV-VI) 67 Psychology of health teaching in the middle grades deals with life of real children 67 Program for health work 67 Rules of the game 68 Weighing and measuring 68 Health habits 70 CONTENTS. Page. Middle grades ( I V-VI ) — Continued. Inspection 71 Mid-morning lunch 72 Time 72 Health songs 78 A visit to the health king 78 Market reports 82 Grades YII, VIII, and last year of the Junior High School 83 Psychology of health teaching in the upper grades deals with group interests 83 Organization of health clubs 84 The health creed 87 Essentials of the program 87 Weighing and measuring 88 Beauty and strength 89 Training for the team 89 Organization of informational course 90 Physiologj^ that works 90 Community health problems 91 Different types of school work 92 Compositions and songs 92 Good health language work, Grade VII, suggested topics 94 Suggested topics for language for Grades VIII and IX 94 Songs 95 Manual training 96 Cooking 96 Suggestive five-minute talks 98 Health standards for elementary schools 101 Bibliography : Reference books for teachers 103 Supplementary reading for children 105 PURPOSE OP THIS PAMPHLET. Probably no field of education within the last two years has shown more originalit}^ and vitality than that of health education. Experiments have been made not only by individual teachers but by groups of teachers on a large scale. In the midst of such inter- esting developments the need of a sound program of health educa- tion extending through the grades has become insistent. In this pioneer field certain ideals, principles, and methods have earned merited approval, but the work done has been limited to particular problems. Every serious student of the health situation feels this keenly, but the time is not yet ripe for a definite and complete course of study in health teaching. The whole field is still in a somewhat uncertain state. Educators in general have lost faith in the old- fashioned methods. This pamphlet is presented mereW as a sane basis for wider experimentation. It attempts — 1. To define the goals for an effective program of health educa- tion in the schools. 2. To analyze the various factors of school and community that form an integral part of this program, such as board of health, school physician, family physician, school and family dentist, school nurse, teachers, and parents, and the contri- bution that each, if properly cooperating, may be expected to offer. 3. To outline in a general way the school health activities and the methods of teaching that may prove successful. While the cooperation of clubs and various organizations with the school is desirable, it can not be made too emphatic that school programs must emanate from the school itself. Any other policy is doomed almost inevitably to failure. School people are likely to resent " meddling with the schools." Any program imposed upon the PURPOSE or THIS PAMPHLET. schools by outside influences will be likely to promote a formal rather than a vital reaction in health education. The obvious limitations of the program suggested by this pamphlet have already been pointed out. Teachers, parents, and others inter- ested in the health of the school child are asked to study it with care; to test it through school and home practice wherever possible. After doing so, kindly communicate with the Division of Hygiene of the United States Bureau of Education. Make definite and con- structive criticisms and suggestions. These will be carefully filed, and this pamphlet will be revised as soon as the occasion justifies. 10 I. GENERAL SUGGESTIONS RELATING TO HEALTH EDUCATION IN EVERY GRADE. The Goal of Health Education is Healthy Children. THE worth of any educational process is to be measured by its product. Health teaching in the school is successful to the de- gree that it conserves and promotes the health of the school child. The mere acquisition of information, no matter how important it may be, is worthless unless it leads to hygienic habits of living, a reserve force of energy, mental poise, and all the other conditions involving happy robust health. This means that children who enter school in first-class health should retain it, and those who are not in good condition should improve steadily, so that at the end of every child's school career he may be as nearly perfect and physically fit as possible. Such an achievement would contribute most effec- tively to the learning processes of the school. It would save much time and add to the happiness, efficiency, and prosperity of the indi- vidual citizen, the home, and the Nation. Every Child Entering School Needs a Thorough Physical and Mental Examination at School Entrance. The strategic moment to begin health education in the schools is when the child first enters school. The chauffeur would not think of going on a long trip without first having his car thoroughly exam- ined. Likewise we should have as thorough a knowledge as possible of the child who starts his long educational journey from the kinder- garten or first grade through the high school. The physical exami- nation should be made, if possible, in the presence of family physi- cian, teacher, and at least one of the parents. This insures a common basis of understanding and sympathy between those most concerned 11 HEALTH TEACHING. with the child's welfare. It also makes possible the continuation of the work of the home and intensifies the teaching through the influ- ence of the group of what was formerly individual instruction. Children who drink milk unwillingly at home are often keenly inter- ested in drinking milk with their companions at school through the influence of the group. It is also desirable that each child should have a mental examina- tion at school entrance. The attractive picture-game tests now available make it possible to detect serious mental defects and to adjust the child to a curriculum suited to his capacities and inter- ests — a necessity for robust mental health. Individual Health Training Through all the Grades is Vastly More Important than Any Crystallized Course of Study. The health instruction and training most valuable for any boy or girl depend on the needs of the individual. The girl with bad posture needs personal help. A boy much underweight may need suggestions on taking more rest rather than doing strenuous work in a gym- nasium. If we could deal with each child according to his needs from the kindergarten through the high school, we might expect to get a product in health at the end of his school life to be proud of. This principle of instruction should be the core of the health work through all the grades. Every teacher and parent is herehy warned against aeeepting the most perfectly worked out course of study in health teaching in plox^e of a remedy for the individual needs of the individual child. Weigh and Measure School Children Regularly. We have long known in the case of infants that weight in proportion to age and height is an index to health. We now know that this same principle applies also to older children. Children who do not gain normally in weight or are 10 per cent or more below the standard have physical defects or bad habits of living. Regular weighing and measuring of children indicate (1) the general condition of health and (2) whether, in comparison with the previous records. 12 HEALTH TEACHING. there has been any improvement. All children should be ^Yei<^hed every month and measured at least twice a year. Report ^y eight to Parents each Month. The height and weight should be sent to parents regularly, and both children and parents should be impressed with its significance and the desirability of making the normal gain in weight. This is one of the best ways of securing the interest and cooperation of parents. These report cards are being sent out now by several school systems in this country. In one city the card sent out has on one side a place for two years' records, and on the other the Rules of the Game, the habits which every child needs to form to gain in weight and be healthy. The card looks like this : NEWTON PUBLIC SCHOOLS. Weight Card. nelgM. ^rJS* 4t'a'. T»«^'- 1 TTpic^ht Standard Actual Height. ^g.gj^^ ^^g.gj^^_ To gain. Sept i • Oct 1 ! Nov ; • Dec Jan 1 Feb Mar Apr May . June i A range of 10 per cent of average weight below and 15 per cent above is satisfactory. Sept. age. 19 " *' 19.... 13 HEALTH TEACHING. THE RULES OF THE GAME. A full bath oftener than once a week. Brushing the teeth at least once every day. Sleeping long hours with windows open. Drinking as much milk as possible, but no coffee or tea. Eating some vegetables or fruit every day. Drinking at least four glasses of water a day. Pla}dng part of every day out of doors. A bowel movement every morning. SIGNATURE OF PARENT OR GUARDIAN. Associate Pleasure with the Practice of Health Habits. The formation of a habit usually requires considerable repetition and a long period of time under the most favorable conditions, and unless pleasure is in some way associated with its practice it will not be established. It may lapse. One of the most important dis- coveries in modern teaching is the comparative ease with which habits may be established when play is involved. The most pro- gressive work in health teaching in the grades within the last few years has been done by those teachers who have made the practice of health habits an enjoyable game. Composing health rhymes, stories, and songs, making posters, and dramatizing have been used in playful but effective ways. The pages that follow will offer many illustrations of the application of the play spirit. Utilize Opportunities at School to Establish Health Hahits. Children at school may be trained in a number of desirable health habits. There are those habits of a personal nature, such as having 14 HEALTH TEACHING. clean hands and faces, cleaning the teeth, and having correct posture. Then there is another group of habits that might be regarded as a part of school housekeeping, such as dusting, erasing blackboards properly, consulting thermometer, and adjusting window shades. At school, on the playground, and going to and from school there is need of cultivating habits of safety. Not only should all children be instructed about the danger of crossing the street directly in front of a moving car or automobile, but older children may bo encouraged to help the younger children. Assign a Definite Amouyit of Time on the School Program for Health Inspection and Instruction. Some kind of inspection of children, either by the teacher or a com- mittee of pupils, to find out whether pupils have cleaned their teeth, slept with their windows open, drunk their milk, and eaten green vegetables should be made frequently in the lower grades, perhaps daily, and as often as may be necessary in the upper grades, so that habits will not lapse. The time required in any grade will vary with the kind of homes the children come from and their previous training. From 5 to 10 minutes daily are usually necessary for such inspections. Most courses of study provide for instruction in physiology through most of the grades. An average of about 30 minutes per week is as- signed to the lower grades and an hour to the higher grades. In many schools the material presented has been so distasteful to both teachers and pupils that this time has been easily diverted to the so- called fundamental subjects. This amount of time if now used for the most progressive and fascinating health teaching will prove satis- factory. Many teachers are finding a splendid opportunity to impress ideas of health by correlating the health work with other subjects of the school curriculum. The subject matter of language, drawing, arith- metic, and manual training can often be illuminated with health material. Making health posters, writing health rhymes or compositions on actual w^ork done, computing the number of calories consumed for different meals, making an iceless refrigerator — all such activities help to vitalize the regular school subjects as well as to promote health knowledge and habits. 15 HEALTH TEACHING. Enlist cooperation of parents and community. Since many of the fundamental health habits must be formed outside of the school, the successful teaching of health depends in large measure on the cooperation of parents. One of the best ways to get this support is to send home each month a report to the parents of the height and Aveight of the children, and a statement of what the weight ought to be. The parent-teacher association, the news- papers, the school physician, and school nurse may all be useful in enlisting the interest of the parents and community. Philanthropic and social organizations, like women's clubs, the Red Cross, antituberculosis associations, and others, invariably are willing to give assistance if they are shown just what they may do to cooperate. Scales for schools, milk for malnourished children, hospital attention for poor children, and additional school nurses have been provided for in this way. Many a community will find means to meet the health needs of school children if school departments will only reveal these needs, invite cooperation, and lead the way. Too long have school officials been concerned with mental development alone. We now know the importance of a better physical foundation on which to build for mental development. The following letter, sent to parents in one city, illustrates a method of securing their cooperation : To the parents: REPOKTS on the weight of school children are now being sent to the homes each month by the schools. An effort is being made to get children inter- ested in their own health habits and growth and to find out which children are definitely underweight and so need special attention. It is desirable that parents know more about just what the schools are trying to do and the signifi- cance to be attached to underweight as an indication of health conditions. There has been prepared by Dr. Thomas D. Wood, of Columbia University, one table for boys and one for girls, showing the average weight for each height of each age from 5 to 18. To be slightly underweight means nothing, but for your boy or girl to be as much as 10 per cent of the average weight underweight means that a careful inquiry should be made by his parents to determine whether or not there are other evidences of undernourishment and poor health habits. This responsibility is not met simply by taking the child to the physician. It means also careful attention to the formation of correct health habits in the home. The child within the margin of safety, 15 per cent above or 10 per cent below the average weight, should be assured of his success physically and should be encouraged to maintain it. Those below this 10 per cent range should be stimu- 16 HEALTH TEACHING. lated to form better health habits, and so to gain steadily in weight. Growth and good health habits are fundamental and are far more important in his life than simply the child's progress in the traditional school subjects. In every case success and gain are to be emphasized, not failure and underweight. All the children are working toward the goal of greater strength and beauty — some to maintain, others to gain. Let us hope that the day is near when all school officials and teachers will place health as the highest ideal in education. We ask your cooperation along the line of the health habits we are trying to teach. The " Rules of the Game " are : 1. A full bath more than once a week. 2. Brushing the teeth at least once every day. 3. Sleeping long hours with windows open. 4. Drinking as much milk as possible, but no coffee or tea. 5. Eating some vegetables or fruit every day. 6. Drinking at least four glasses of water a day. 7. Playing part of every day out of doors. 8. A bowel movement every morning. If there is no other important evidence of undernourishment than underweight, this condition may sometimes be a family characteristic or a race characteristic. The schools are trying to call to your special attention your child's underweight where it amounts to more than 10 per cent of the average for children of his height, and they are also assuring you of your success in your child's physical development. If your child is not over 15 per cent above average weight it is not an indica- tion that need give you concern. As one teacher said, " It is money in the bank." A reasonable percentage of overweight as the child approaches adolescence is considered a physical advantage if such overweight is not due to soft, flabby fat and wrong health habits. Mid-morning luncheons at school are a strong factor in bringing about good health conditions. It is interesting to see many children who do not like milk or soup at home take it at school with no objections, through the influence of the group. It is also interesting to see the change in attitude toward " eating be- tween meals." Many children do not get enough food by eating only three times a day. They do not eat enough at one time ; they do not want it. Conferences are invited with parents who wish to discuss the new trend in health education. All parents will find the pamphlets issued by the United States Bureau of Education, Washington, D. C, helpful. Many of these are free; others can be purchased from the Superintendent of Documents, Wash- ington, D. C. Very truly, yours, (Signed by principal.) In Kansas City, Mo., the department of physical education and hj^giene of the public schools sends home "A Suggested Health Pro- gram for a School Child's Day '' to the parents. This program is the basis of much of the health teaching in the grades and is sent 44807°— 21 2 17 HEALTH TEACHING. home to enlist the support of the parents for the work with the chil- dren. The following is a copy of the program for the child's day : Rise. Clean teeth. Drink glass of water. Wash (bath, if possible). Play out of doors a short time. Visit toilet. BREAKFAST : Cereal (well cooked) or eggs. Fruit. Milk or cocoa. Hard toast and butter. Mid-morning lunch (for undernourished children) of milk or bread and real butter. AYash hands. LUNCH : A simple meal, which should include milk and fruit (or a green vegetable). Clean teeth. Mid-afternoon lunch (for undernourished pupils) of milk or bread and real butter. After school drink a big glass of water (drink water at each recess time at school). Play and work out of doors an hour or more. Wash. DINNER — (1) For older children: Soup (cream of vegetable soups are especially wholesome). Small piece of meat or meat substitute (eggs, milk, cheese, nuts, beans). Potato or potato substitute ( rice, macaroni, hominy, etc. ) . Another vegetable, frequently a green one. A simple dessert — fruit preferred. Milk to drink. (2) For small children: An early, light supper of cereals, fruit, and milk. A short, happy evening at home. Clean teeth. Early bedtime, from 7 to 9 o'clock, according to age. Sleep long in fresh air. The Teaching of Health Should Be Connected with Citizenship. Getting children to realize a personal need for following the " Rules of the Game " is an effective motive, but another which should not be neglected is that of doing something for the general 18 HEALTH TEACHING. good — being of service to one's playmates, school, and community. Stimulating children to organize into health clubs to look after personal cleanliness and the sanitation of the schoolroom and yard has proved popular and satisfactory among many teachers, par- ticularly in the upper grades, but fostering the ideas of health service to others can be carried out in the lower grades without any special social organization. One danger in correlating health with civics is obvious — the civics may be emphasized to the exclusion of hygiene, but we must realize that health with civics is more important than civics without health. Physiolog}^ and anatomy should be taught for the purpose of en- couraging health habits and to satisfy children's interest in their bodies. The teaching of physiology and anatomy in our public schools has been so barren of results that we are now in danger of discarding them entirely. This would be a serious mistake, because all are in- terested in their own bodies. Such knowledge within certain limits is just as legitimate as a knowledge of trees or flowers, and much more important. Such information when properly organized shows the desirability of forming certain fundamental health habits. While physiolog}^ should never be taught for its own sake, some of it, if carefully selected, might be taught with profit in all grades, particularly beyond the fifth; but in every case teachers should re- member that doing ratlier tJwjti knowing is the final goal. Encourage and Definitely Plan for Physical Exercises and Play in Every Grade. Vigorous, happy, physical activity is a necessity for health. It develops strong muscles, good lungs, a keen appetite, good digestion and elimination, stimulates efiicient mental activity, is a preventive of bad posture, gives standards of good posture, and promotes robust health. In the form of play it particularly contributes joy and hap- piness to life. While the formal gymnastic exercises may be de- sirable to correct bad posture or to give some sort of relief between recess periods in school, they are too often regarded as work. Such exercises when given should not be too formal, but playful, some- thing in which the children participate joyfully. Plays and games in the open air are to be especially encouraged. Nothing can take their place. The school should look beyond the school life of the child and try to encourage and develop such an 19 HEALTH TEACHING. interest in physical activity in the out of doors that it will extend later into adult life with its fruitage of health and mental poise. In contributing to such an end, nature clubs, walking parties, skating, and photography are invaluable in developing an " out-door-mind- edness." The physical director should be a powerful factor in the health work of any school system. His influence in furthering morale in life, in encouraging a lasting interest in wholesome out-of-door ac- tivities, is incalculable. In this sphere his influence may touch all the children of a school system. Strive to Develop Wholesome Interests and Attitudes in Your Pupils. Health does not mean simply having a healthy set of organs or even observing the rules of hygiene, such as getting fresh air, exer- cising, and eating nourishing foods. Human beings often have sound physical bodies and observe all the rules of physical hygiene, and yet in life become excessively nervous, and suffer what is known as a breakdown. The prevention of these unfortunate con- ditions is in the sphere of mental hygiene. It can not be taught from books or in any particular course in the grades, because it finds its application in all the activities of the school and life itself. Contrary to popular belief, the causes of strain and breakdown are not usually hard work. According to Dr. Dearborn, they have their basis — rather in the overambitions and disappointments, in the worries and mental conflicts, in the humdrum and monotony of the daily tasks, which offer little chance for individual initiative and self-expression. * * * Mental stress and strain begin when one's work is not the expression of desires, but conflicts with them. The adjustment of the work of the child to his varied interests and capacities, the elimination of Avorry, allowing freedom of emo- tional expression in music, art, dramatization projects, and other work of the school, the cultivation of normal social relations, power of self-control, the spirit of service and cooperation, and a sense of personal honor — all these make for balance, sanity, efficiency, and happiness. One principle of mental hygiene in connection with regular health teaching which every teacher should remember is the desirability of stimulating pupils to think about the satisfactions of healthy living rather than about disease. 20 HEALTH TEACHING. The teacher who realizes that she is teaching life, not subjects, and children, not facts, is likely to deal with pupils sympathetically and effectively so they can cultivate and realize their better selves. Children soon forget the facts they learn at school, but attitudes remain. School Physicians are Needed, Except in our larger cities and towns school physicians are not generally employed. They are exceedingly rare in the rural dis- tricts. Invariably they are employed only part of the time and are poorly paid. In most cases their work must therefore be very super- ficial. We are in great need of school physicians who can sympa- thetica 11}'- devote as much time as is needed to the health of the children in the schools. When the school physician first made his appearance he spent his time, as he does now in most cases, in detecting and preventing con- tagious diseases. This is highly desirable and should continue, but the school 23hysician is now seriously needed in helping to build up the vigorous health of boys and girls. He should have adequate time to advise teachers, school nurses, and parents; and he should be adequately remunerated. In some communities the Red Cross or some other social agency, on the invitation of the school department, can do no better work than to furnish school physicians and nurses until the health of the school children is established or until the people realize the value of the work and assume its responsibility. School Nurses are Needed as a C onnecting Link Betioeen the Home and the School. The school, if properly administered, should look after the child's health while in school, but school training is inadequate unless the home cooperates with the school. The teacher may have some con- ferences with parents and inspire cooperative effort through parent- teacher associations, but she does not have the time and usually not the training and prestige in health matters which fit her for the intimate home conferences with parents that are so vitally necessary for success. It is here that the nurse is necessary. She has training and prestige in the community in health subjects, and can be in touch with school physician and teacher. She may convince the parent of the need of removing Frank's diseased tonsils or seeing that he gets plenty of fresh milk to drink every day. 21 HEALTH TEACHING. Carefully checkecl-up experiences in the schools show a tremendous difference in results between those schools that have no school nurses, or an inadequate number, and those in which the service is satis- factory. In some schools the school nurses are expected to do all the health teaching. This is a serious mistake. The teacher is with the children constantly, and with her leadership children will be much more suc- cessful in health matters. The teacher, however, needs the advice and hearty cooperation of the school nurse. The teacher is not expected to be equipped for diagnosis of disease, since that responsi- bility should rest with the medical profession. There Should he Standards for Promotion and Graduation in Health as in any School Suhject. Tn order to get the best results in health teaching we must demand that children come up to certain standards in health for promotion and graduation. It is a noticeable fact that, in those States where children are required to be in a certain condition physically before they are given their working papers, both parents and children become interested in the child's development in health. The general public is not yet ready to adopt such a procedure, but there are schools where doubtless such a plan could be inaugurated. It would vitalize all the work in hygiene tremendously. The intelligent use of scales in every school office where working papers are issued would haA^e a far-reaching influence. To he Successful in Health Teaching^ the Teacher Needs to Exemplify What She Teaches. It is about as inconsistent for an anemic, stoop-shouldered, dis- gruntled, and underweight teacher, or a heavy, flabby, loggy, lazy teacher to teach health as it is for a moral reprobate to teach ethics and inspire moral living. The teacher who is healthy — mentally and physically — teaches health by contagion. Every teacher should try to build up for herself a vigorous body, a serene and well-balanced mind, and a buoyant spirit. If you are trying to teach health, are you yourself following the Rules of the Game? The evidence is growing that teachers who take a keen in- terest in health teaching invariably gain robust health and establish more normal weight. They can't do otherwise. 22 HEALTH TEACHING. Interesting teachers in their own health is a tonic for health teaching. Improving and conserving one's own health is a new goal for the teacher as well as for the children. To realize the fun in playing the Rules of the Game, properly to inspire the children, the teacher needs to participate in the activities of the children. To be weighed when they are weighed, to drink milk with them at recess, to get proper hours of sleep and recreation, to wear hygienic shoes, the right kind of clothes on rainy days, to meet the disagreeable situa- tions of the day with confidence and good cheer, to do these things is to be not only a better teacher of health but a better teacher in every way. Eome Health Teaching Every Teacher May Do. There are thousands of schools without school nurses or school physicians, in school buildings that are inadequate and unhygienic, and in communities that are ultraconservative. Yet even with these handicaps every teacher may do something. Here are a few sugges- tions : 1. Read the pamphlets on health teaching issued by the United States Bureau of Education, Washington, D. C. 2. Read at least one good book on health each year. (See Bibliogra- phy on pp. 103-106.) 3. Get children interested in forming health habits, like cleaning their teeth, bathing more than once a week, eating green vege- tables, and sleeping and resting properly. 4. Tr}'- to weigh and measure all your pupils. If you do not have scales, perhaps somebody in the neighborhood has some you might use — a groceryman or a farmer. 5. Try to get cooperation of parents. Organize a parent-teacher association, or, if you already have one, see that health topics are introduced. Invite your county superintendent of schools or a physician who has standing in the community to speak. Try to get parents to the schoolhouse, so that they may see unhygienic conditions and take an interest in their correction, also in discussing the health of the children and what they may do to help. 6. Have the children discover the conditions and plan the remedies by their own work and by enlisting the cooperation of the community. 23 HEALTH TEACHING. A Course of /Study for any Grade Should he Worked out with the Cooperation of Successful Health Teachers in that Grade. • Such a plan will educate and interest the teachers, because they will feel that they had some part in making the program. It is also likely to be better adapted to the needs of the community. Children living in a community where malaria and hookworm are prevalent will need to have certain things emphasized that would be unneces- sary in another commimity having good sewerage and drainage. It is also more likely to be adapted to the interests and capacities of the 13upils, because it will contain many suggestions that have been tried out Avith children of that particular grade and locality with success. The working out of a course of study in health for any system of , schools should involve the cooperation of a large number of teachers ' for at least two or three years. A Good Health Slogan. Fashion plays an important part in life. One system of schools has taken as its slogan, " LET'S MAKE HEALTH FASHIONABLE." In these schools children talk about what they are doing and what they intend to do to gain in weight. Health is on the tongues, in the hearts, and in the homes of the children. What will you do to make health fashionable in your school and in your community ? Special Health Classes Are Needed for Malnourished Children. There is a class of children habitually 10 per cent or more under- weight that can not be helped sufficiently in every case by the ordi- nary class work. For such pupils a health class should be organized, with an experienced physician as adviser and health nurses for follow-up work in the homes. Such classes are sometimes called "nutritional clinics," a name which suggests to the child, parent, and general public something which savors of disease and is gener- ally distasteful. Special health classes is a better name. In some communities these so-called nutritional clinics have been established, unrelated to any health teaching in the schools ; but there has been no campaign to promote the general health of all the school children. Such a general educational campaign would give both 24 HEALTH TEACHING. children and parents a wholesome and valuable point of view and make Avay for the special health classes on a broader and more suc- cessful scale. Domestic Science Courses Should Deal Definitely With Health Habits. Courses in domestic science, like other courses in science, have so often been satisfied when pupils gained a certain amount of informa- tion. They have seldom, if ever, checked up results in terms of the actual health achievements of the pupils. This should be considered of vital importance. If pupils are weighed and measured with regu- larity, they may study the problem of foods and marketing from the point of view of their own individual needs. One teacher of domestic science found that 64.7 per cent of her pupils were under- weight. At the end of five months the percentage had been reduced to 29.8 per cent by exactly this kind of work. These same girls, as a ]3art of the domestic-science course, assumed the care of younger brothers and sisters who were underweight. They helped prepare the kind of food that children should eat, and watched other health habits of these children at home. Such a knowledge of the feeding of children is of great practical value and should be incorporated in every course of study in domestic science. It is also true that many of the girls who study domestic science in the grades will never go into high school. Because they will ultimately assume the responsibilities of a household and children, there are added reasons for the study in the grades of the feeding of children. Boys should be encouraged to study domestic science also. There are manj^ occasions in the life of every boy and man when such a knowledge and art would be very helpful. Then, too, it is another way of getting boys interested in the practical study of their own health and that of the family and community. By skillful man- agement the traditional and conventional prejudices against it may be disposed of. School Furniture Should he Adjustable and Adjusted. Upon entering a schoolroom it is pitiful to see how many children are sitting: on seats where their feet do not touch the floor. It is de- 25 HEALTH TEACHii^G. plorable how many teachers expect good penmanship and good pos- ture from children who are sitting in seats utterly unfitted to them, at desks entirely the wrong size. Many teachers are not even con- scious of the necessity for comfortable, properly adjusted school furniture, so long have they been accustomed to poor, ill-fitting chairs and desks. They have no standards. They take what is given to them. They must learn how to secure what the child needs for his best physical development. Sometimes the remedy is as easy as knowing how to adjust the desk and the chair to the need of the individual child. This adjustment should be made twice a year by the teacher without waiting for the uninterested janitor. " Healthful Schools," by Ayres, Williams & Wood, contains definite directions for adjusting desks and chairs for school children. The Hygiene of the Eye and Ear. The normal functioning of the eyes and ears of school children is important for at least two different reasons : First, they are two of the most important sense organs involved in the learning process; and, second, any defect in these organs is likely to be accompanied by conditions having a far-reaching effect on the general health. The teacher should know whether her children have perfect sight and hearing. These facts may be determined largely by an examina- tion given by the school nurse or teacher. For the eye the Snellen chart is commonly used. Another chart for school use has been prepared by Dr. Frank Allport. Complete directions for the exami- nation of the children's eyes accompany the chart. Such an examina- tion is particularly good in revealing shortsightedness. However, a child may read the chart perfectly and yet have a very serious kind of eyestrain. He may be farsighted or have astigmatism and see only with the expenditure of a tremendous amount of energy. Chil- dren should not only be tested by such a chart but an inquiry should be made as to whether the eyes ever itch, burn, run, or are sensitive to light. The teacher should see whether the eyes twitch or cross, whether the child frowns much or has peculiar positions when look- ing at things. She should ask whether the letters seem to run to- gether, look crowded, blurred, or foggy; whether they jump up and down and seem jumbled; whether two lines are ever seen in place of one. She should notice whether short, easy, familiar words are often miscalled in reading. Complaints of headache, dizziness, and nausea are often due to eyestrain. 26 HEALTH TEACHING. It is the business of the oculist to make a diagnosis of the eye trouble. When necessary, as a result of the school examination of the eyes, parents should merely be advised to consult an oculist. "When parents do not respond in a reasonable length of time the school nurse should do follow-up work in the home. Charitable organizations and hos- pital clinics will often assist materially in providing for an oculist's examination and the necessary glasses when parents are unable to bear the expense. No child should suffer from eyestrain, whatever the parents' circumstances. It is far more necessary to provide a child who needs them with glasses than it is with books. A committee of the National Education Association has recom- mended the following rules for the preservation of the eyesight : Take care of your eyesight ; upon it depends miicli of your safety and success in life. Always hold up your head when you read. Hold your book 14 inches from your face. Be sure that the light is clear and good. Never read in the twilight, in a moving car, or in a reclining position. Never read with the sun shining directly on the book. Never face the light in reading. Let the light come from behind or over your left shoulder. Avoid books or papers printed indistinctly or in small type. Rest your eyes frequently by looking away from the book. Cleanse the eyes night and morning with pure water. Never rub your eyes with your hands or an unclean towel, handkerchief, or cloth. These are rules which we knoAV should be followed, but let us en- courage the children to form the habits which secure these results rather than impose rules upon them. One interesting way of taking this up in class would be to get the children to write a play involv- ing some of the habits referred to. Let them sit around as a family and demonstrate the correct position and habits in regard to the light. A simple method of testing the hearing is the whisper test. The pupil stands with his back to the teacher at a distance of 20 feet. The teacher whispers several things which he is asked to put down on paper, or he is instructed to do certain things, like holding up his right hand, touching his head, etc. Another test is the watch test. The teacher holds an ordinary stop watch 3 feet from the pupil, on a level with his ear. The dis- tance between the watch is varied from time to time so that the teacher may find out the least distance at which the pupil may hear distinctly. The stop watch is better than an ordinary watch, be- .27 HEALTH TEACHING. cause it is more accurate. Often the pupil thinks he hears when he does not. If pus or foul odor proceeds from either ear, or there is frequent complaint of earache, something serious is involved and should be attended to. Children must not be allowed to suffer from earache. Reports on the ear, like those of the eye, should be sent to parents, and the procedure in getting results should be similar. Look After the Care of Children's Teeth in Every Grade. One of the essentials of happy, healthy living is good mastication of food. This depends in part on the habit of properly chewing the food, but this can not take place unless, first of all, teeth exist and are in a proper condition for chewing. The investigations of the teeth of school children show that 8 out of every 10 children have decayed teeth. This condition is deplorable. Many of these children suffer from toothache, absent themselves from school frequently, and carry on their work with difficulty. Recent studies emphasize the relation between decayed teeth, rheumatism, chronic joint diseases, heart disease, and other disorders. Often, too, it is found that permanent teeth, especially the 6-year molars, are missing or are very crooked in their arrange- ment, making ugly faces which might otherwise be beautiful. From the point of view of health and personal appearance, the hygiene of the mouth is one of the most important and persistent of health problems, yet a normally healthy mouth is possible for every child. The first step in this educational campaign is to get children in tlie habit of cleaning their teeth regularly at least twice a day — after breakfast and before retiring at night. Dental floss should be used at least once a week. Among some families and in some schools one difficulty is that of supplying the children with tooth brushes and paste. But tooth brushes and paste can be bought by the school at wholesale at very reasonable prices, and in only rare instances will parents refuse to furnish the money. Sometimes children may be urged to save a few of the pennies which they spend for candy and buy a tooth brush and ]:>owder. The regular commercial tooth powder or paste is not abso- lutely necessary. Water made salty to the taste, or precipitated chalk, Avill answer. It is the brushing of the teeth that counts most. 28 HEALTH TEACHING. It is very important to get children to brush their teeth so as to make them clean, and also to prevent the pushing back of the gums from the teeth, thereby facilitating decay. The most suc- cessful teachers find it desirable to demonstrate to a class personally just how the toothbrush is to be held and used, first by holding the toothbrush in mid-air and going through the movements and next by actually brushing the teeth. Then the children may be led to do the same thing under the watchful eye of the teacher. The tooth- brush drill is now required from time to time in the lower grades in many cities. The habit can not be established unless the children brush their teeth at home. The best way to bring this about is to have daily morning inspection of the teeth in the lower grades, and, as the habit becomes more nearly automatic in the higher grades, to have inspections less frequently. The children may often do this and give their report to the teacher. Teachers resort to various devices to encourage class pride in clean teeth. One teacher draws a number of squares on the board, each one referring to a school day in the month. If all report ha^dng cleaned their teeth, the square is made white; if anyone fails, the square is colored red. The game is to keep the squares white. Although the actual inspection of children's mouths in most cases may be made by class inspectors, the teachers should occasionally make a personal inspection, complimenting those who have clean mouths and cautiously advising those who have not. It is part of the teacher's job to know the condition of the children's mouths. If every teacher will occasionally carefully inspect the mouths of her pupils and make a record of the number of teeth decayed, she will be surprised to find how few children have no decayed teeth. She will be painfully surprised to find the large number of teeth that are decayed down to the gums and surrounded by inflamed- looking tissue or pus. The aid of the dentist is then imperative. Decayed teeth that can not be saved should be extracted and the others should be filled. In many cases the teeth need to be cleaned by the dentist. Although the teacher need not always report her findings directly to the parents, her inspection will make her realize the need of caring for the children's teeth and stimulate her to do more effective teaching concerning the proper care of the teeth. Every school system should have an examination of children's teeth at least once every year by doctor or nurse and a report made 29 HEALTH TEACHING. to the parents. The follow-up work in the homes is the privilege of the school nurse. When parents are unable to take their children to a regular dentist, a dental clinic connected with some hospital or under the direction of the board of health or school board is often available. Such clinics must be much more generally provided in the future as a most important means of preserving health. Cooperation Among all of Those Agencies Working for the Health of Children is Imperative. Among those people that touch the health of school children are parents, teachers, school nurses, school dentists, school physicians, physical directors, domestic science teachers, and special nutrition workers. Each of these forces probably has an exaggerated notion of its own importance. The school physician, for example, often thinks that his part in the health work is all important. The physi- cal director is likely to have the same misconception about his con- tribution to the health program. The truth is that they are dealing with the same children and cordial cooperation among them is ab- solutely imperative. Since the teacher has daily contact with the children, the initia- tion and supervision of health habits should be largely under her direction. Any plan which neglects this important aspect of train- ing in health habits is defective. The teacher recognizes, however, her frequent need for the advice of the school physician, who should have a vision beyond simply the prevention of contagious disease and the removal of physical defects, toward the building up of the general health of all the children. There should also be the finest kind of cooperation between the teacher, school physician, school nurse, parents, and family physician. The physical director, the teacher of domestic science, the music teacher, and the drawing teacher should all eagerly search to find the way to make their Avork fit into this great plan. In a very few cities splendid cooperation of all these agencies is being secured by a director of health education who is responsible for the health of the school children. 30 II. MORE SPECIFIC SUGGESTIONS RELATING TO HEALTH EDUCATION IN THE GRADES. IT is possible in many school subjects to outline specifically the work of the various grades. In arithmetic plans ma}' be made in each grade to cover so many pages of a textbook and to gain a certain skill in handling particular combinations, and so definite work may be accomplished. Health Teaching Is Hah it Formation. Health teaching is quite different. Subject matter in textbooks may be planned for. it is true, but the essential thing in hygiene is the practice of health habits until they become automatic. The es- tablishment of such habits can not be planned for as systematically as the learning of facts and the gaining of skill in arithmetic. First, / children var}^ greatly in different schools. The children in one school may come from unfortunate homes, where cleanliness is not common ; they may come to school with dirty hands and faces, heads infected with pediculi, and little evidence of bathing. In another school con- ditions may be reversed. The problems of habit formation are quite different in these two schools. Second, individuals vary so widely in learning capacity that it is impossible to predict how long it will take each one to form a particular habit. Mary may have learned before coming to school to clean her teeth ; even with the teaching of / the schools helping the home, it may take Frank two years and' George three. Intensive concentration on the teaching of a small number of habits in a grade may be successful in getting those habits formed, but there is grave danger that it may lead to nagging the children and to the serious neglect of other habits of fundamental importance. 31 HEALTH TEACHING. It seems wisest to recommend a general attack for the establish- ment of all the fundamental health habits at the very beginning of the child's school career and to continue the attack from different angles until they have been made automatic. Monotonous Repetition Must he Avoided. One of the obvious defects of health teaching is the monotonous re- petition which is so evident in the various grades. This has been due largely to the fact that habits have not been established in a preced- ing grade, and so repetition is necessary. This was reflected recently in a conference on health habits. A teacher in the seventh and eighth grades said, " We need to emphasize cleanliness in our grades." But the teachers of the fourth, fifth, and sixth grades exclaimed, " But our pupils need cleanliness as the main subject," and the first-grade teacher protested, " But we must teach our children cleanliness. They need that most of all." So there seems to be need of training in this habit all along the line. Cleanliness seems to be so difficult a matter that school children are not able to form the habit in the primary, in the middle grades, or frequently even in the upper gram- mar grades, and yet all that we can do for them from the kinder- garten on through the elementary schools, working in cooperation with the home will help to produce cleaner, healthier, happier citi- zens for the high school. The evidence is overwhelming that chil- dren do not form their health habits easily. It takes years to form these habits aright. We are amazed to discover lapses even among the children in our own families — serious lapses. We may even re- member them in our own lives. We must continue to expose our school children to definite health influences with specific results in mind, hoping that they will catch the right kind of contagion of spirit and break out with enthusi- astic health. Approach the Work from Different Angles. In some way we must prevent this monotonous repetition of training in various grades. The remedy seems to be to approach these same habits in the different stages of the child's development from differ- ent angles. Take cleanliness as an example. In the kindergarten and first grade the teacher may show her approval of the children 32 HEALTH TEACHING. wlio have clean hands by g-ranting them special privileges because of their cleanliness, such as passing the crackers, handing out the milk cups, or passing the straws. In the other grades the practice of this habit may be associated with other new and interesting ideas. In the whole early elementary group the approach may be made through the fairy story. Through the fourth and fifth grades the Jiealth teaching can use the child's love of stories by presenting to him actual experiences of children in accomplishing miracles in their own lives and in the life of the community. Books must be written which will illustrate health experiences in the daily lives of children that will give zest and stimulus to each pupil's own health endeavor. The need of cleanliness may be clinched still further and applied more widely to the community life in the upper grammar grades, ' where community hygiene^ may be taken up more vitally. There the problems of taking care of the sewerage, a clean milk and water supply, clean markets and clean streets, clean homes and schools will be prominent. In this more detailed study of the community the pupils find the problem of cleanliness becoming wider and wider in its scope, showing its relationship to a community as a whole, and re- acting upon the individual to promote his own health. In these same upper grades the need of bodily cleanliness may become more impera — tive through the study of physiology in which the physiological aspects are subordinated to the necessary habits. The need of bath- ing, cleaning the teeth, and a daily evacuation of the bowels all as- sume added importance properW related to the physiological back- — ground. Any treatment of this subject would be incomplete which did not also emphasize the glory of a clean mind. A clean mind is the greatest achievement of all habits of cleanliness. The Rules of the Game} It would be possible to enumerate a long list of desirable health habits. It has seemed wiser, however, to take a simple program which is called the Rules of the Game. There are eight in number. Because of the simplicity of the platform many people hardly dare to believe in its power. Those of us who have seen the miracles that can be accomplished in the health life of the children of a community where these rules are in force must acknowledge the efficiency of so simple a plan. It takes faith to believe in so simple a thing as the Rules of the Game, but the biggest things in life can be stated simply. iSee p. 14. 44807°— 21 3 33 HEALTH TEACHING. An analysis of these Rules of the Game show that three of them refer to cleanliness (bathing, cleaning the teeth, and daily bowel movement). Three of them refer to food (drinking plenty of milk, eating vegetables and fruit, drinking water). These rules also emphasize sleep and play. It has been suggested frequently that 2)osture should be added to these Rules of the Game. The desirability of good posture is unde- niable, but it seems quite probable from studies that have been made that malnutrition is one of the foremost causes of bad posture. The stoop shoulders and general " slump " in many cases is undoubtedly due to a child's lack of strength. The teachers of the country will be fortunate when some one has made a thoroughgoing study of the relation between posture and nutrition. If 1,000 children chosen at random could be divided into three groups — good, fair, and poor — according to posture, and a careful study made of the nutrition conditions of each group, some illuminating conclusions might be reached that would guide us in knowing what kind of physical training to give our children. There are careless habits which pro- mote bad posture. These should be prevented and corrected as far as possible. It is doubtful, however, whether any child seriously underweight with bad posture can be trained satisfactorily in pos- ture until the condition of malnutrition has been overcome. The importance of rest as a daily health habit for children of all ages can not be overestimated. This is particularly true of under- weight children. There is considerable evidence to show that many children are being overstimulated. In the establishment of health habits through the grades the health work revolves itself around several different foci, which we might note briefl}^ Weighing and Measuring. I. The important thing for us to get is some standard concerning the physical condition of the child. This may be furnished b}^ careful examinations by the school physicians and follow-up work in the homes by school nurses, but where this is not possible the teacher gets her first revelation concerning the condition of the child by measuring and weighing each one of her children. Height should 34 HEALTH TEACHING. be taken at least twice per jesLV. September and March are the best months. The data upon which the figures of the height and weight of pupils are based in the height and weight table are given in order that the importance and accuracy of these tables may be understood. These are the best that are yet available, according to eminent authorities. The tables were compiled by Thomas D. Wood, M. D., director of physical training, Columbia University, New York, from the fol- lowing sources : 1. Statistics of American children obtained by Bowditch, Holt, Hastings, Porter, Boas, and others. 2. Statistics gathered from 10,000 records of Horace INIann school children collected during the last 18 3^ears. 3. Life insurance statistics for the 15 to 20 year age periods. 4. Statistics by Dublin of school children in Xew York State 14 to 16 years of age examined for issuing of working papers. Children should be w^eighed each month as nearly as possible on the same day, and recorded on the classroom records of the United States Bureau of Education. It is desirable to make no deductions for the clothes of the children, the tables given having been provided for these variations. However, there may be cases of extremely heavy boots or clothing which, in the teacher's judgment, should be allowed for. Although the class record sheet suggests that shoes be removed when the height is taken, since the child's height is never compared with any except his own, and the height of his heels does not vary to any great extent, it has been deemed wise in some places to have the children both weighed and measured in their shoes because of two elements involved — the extra time necessar}^ and the children's occa- sional humiliation because of holes in their stockings. The important fact to be learned is how much the child has gained since he was last weighed. His gain is to be emphasized* not the amount that he lacks of beinoj the averaire weight for his hei^^ht and age. If he is within 15 per cent above or 10 per cent below his average weight, there is no cause for concern, all other condi- tions being satisfactory, and he should be assured of his success. If he is not, however, within this margin of safety, he should re- ceive the attention of the school physician, and the school nurse may visit the home, conferring with his parents, securing their coopera- 35 HEALTH TEACHING. tion, and reporting to the teacher and principal the results of her visit. Reports concerning the weight of all children should be sent home once a month either on the report card or on a special card provided for this purpose. (For sample of such a card see p. 13.) Right height and iveightfor boys. Height (inches). 5 years. years. 7 years. 8 years. 9 years. 10 years. 11 years. 12 years. 13 years. 14 years. 15 years. 16 years. 17 years. 18 years. 39. 35 37 39 41 43 45 47 48 36 38 40 42 44 46 47 49 51 53 55 37 39 41 43 45 46 48 50 52 54 56 58 60 62 44 46 49 48 50 52 55 57 59 61 63 66 69 49 51 53 55 58 60 62 64 67 70 73 77 54 56 58 60 63 65 68 71 74 78 81 84 87 91 57 59 61 64 67 69 72 75 79 82 85 88 92 95 100 105 62 65 68 70 73 76 80 83 86 89 93 97 102 107 113 71 74 77 81 84 87 90 94 99 104 109 115 120 125 130 134 138 78 82 85 88 92 97 102 106 111 117 122 126 131 135 139 142 147 152 157 162 86 90 94 99 104 109 114 118 123 127 132 136 140 144 149 154 159 164 169 174 91 96 101 106 111 115 119 124 128 133 137 141 145 150 155 160 165 170 175 97 102 108 113 117 120 125 129 134 138 142 146 151 156 161 166 171 176 40 41 42. 43 44 45 46 47 48 49. 50 51 52 53 54 55 56. 57 58. . . 59 60 61 110 62 116 63. 1 119 64 122 65. . . . 126 66 130 67 135 68 139 69 143 70 147 71 152 72 157 73 162 74. 167 75 172 76 177 Courtesy of Child Health Organization of America. Prepared by Thomas D. Wood. Age. 5 to 8.. 8tol2. ABOUT WHAT A BOY SHOULD GAIN EACH MONTH Ounces Age. Ounces. 12 to 16 16 16 to 18 8 Weigh on the same date each month about the same hour of the day. Regular weighing and measuring will stimulate children to prac- tice health habits and give them keen interest in their physical im- provement. The Rules of the Game contain excellent principles to be taught during the elementary grades, while the Modern Health Crusade furnishes suggestions for varying the work. 36 HEALTH TEACHING. Daily Teaching of Health Tlahits. II. There should be teaching of health habits every day, both inci- dentally and directly, in many ways, and through many subjects. Means and methods are presented in detail in the pages that follow. Right height and weight for girls. Height (inche!^). 5 years. 6 years. 7 years. 8 years. 9 years. 10 years. 11 years. 12 years. 13 years. 14 years. 15 years. 1(1 years. 17 years. 18 years. 39 34 36 38 40 42 44 46 48 34 37 39 41 42 45 47 48 49 51 53 36 38 40 42 43 45 47 49 50 52 54 56 59 62 43 44 46 48 50 51 53 55 57 60 63 66 68 49 51 52 54 56 58 61 64 67 69 72 76 53 55 57 59 62 65 68 70 73 77 81 85 89 56 58 60 63 66 68 71 74 78 82 86 90 94 99 104 109 61 64 67 69 72 75 79 83 87 91 95 101 106 111 115 117 119 70 73 76 80 84 88 93 97 102 107 112 117 119 121 124 126 129 81 85 89 94 99 104 109 113 118 120 122 126 128 131 134 138 86 90 95 100 106 111 115 119 122 124 127 130 133 136 140 145 91 96 102 108 113 117 120 123 126 128 132 135 138 142 147 98 104 109 114 118 121 124 127 129 133 136 139 143 148 40 41 42 43 44 45 46 47 48 49 50 51. 52 53.. 54 55... . 56. 57 58. 59 60. 106 61 111 62. . Ho 63 119 64... 122 65. 125 66 128 67. 130 68 134 69. 137 70. 140 71 144 72. 149 Courtesy of Child Health Organization of America. Prepared by Thomas D. Wood. ABOUT WHAT .V GIRL SHOULD GAIN EACH MONTH. Age. 5to8 Ounces. 6 Age. 14 to 16 8to 11. 8 16 to 18 11 to 14 12 Ounces. 8 4 Weights and measures should be taken without shoes and in only the usual indoor clothes. thereby answering the insistent question as to how time is to be found for a new subject and how it may be presented. Milk Luncheon. III. Supplementary work for nutritional purposes for some children and for educational purposes for all is found in the mid-morning 37 HEALTH TEACHING. luncheon of crackers and milk. In one city that has made a record in building up the health of its school children, a school principal said to his teacher, " If 90 per cent of your children are not taking the milk lunch, either 3^ou are not awake to the importance of this Avork or you are not on your job." Both teachers and parents have observed with satisfaction that children who refused to drink milk at home wished to join the luncheon at school and that they gradu- ally learned to drink milk with the others. The educational value of the mid-morning luncheon is only dimly appreciated as yet in this country. The children's capacity for work is greatly increased by the mid- morning luncheon, and so valuable time is added to every day. One school district of 946 children in a progressive city is now buying about $5,000 worth of milk and crackers a year. In spite of a fear on the part of some teachers that the distribution and drinking of milk and eating of crackers takes too much time, this is done in this city so systematically and with so much ease that the regular program is not upset, and the children are taught a rare lesson in health and good citizenship. Older children take turns in getting the bottles and pouring out and passing the milk. In good weather many of the children drink their milk out of doors. The children in the upper grades find a valuable project in keeping the books, doing the arithmetic, and looking after the financial relations involved. In this city many teachers find this mid-morning lunch a great help in their work and Avould be very unwilling to give up this experience. The relation between this luncheon and increase in weight is interesting. In most cases the children have gained steadily in weight, and they have more concentration and ability to work the last part of the forenoon. Needless to say, in those cases where children have come to school without any breakfast, whether they were in too much of a hurry to stop to eat it or for any other rea- sons, the value of these luncheons is unquestionable. The educa- tional aspect of the luncheons is also valuable. Children can be taught to eat in groups food that is good for them which they often refuse at home. They drink milk and eat vegetables in soup because all the other children are doing it, and so are helped to establish the habits of eating these foods. The luncheon should be paid for by the children wherever possible, but a fund can often be arranged so that each teacher can take care of those children who need it but who can not afford the luncheon. 38 HEALTH TEACHING. It is often possible for some children whose parents prefer it to bring their own milk and other food from home. The hot lunch at mid-day also offers a splendid opportunity for health lessons. A cooperative plan may be inaugurated whereby the children make contributions for this meal. This should involve a discussion of food values, so that there ma}^ be a balanced and nutritious meal. Tlie question of cooking would also be included. Many schools have been able to get the necessary equipment at a reasonable expense, and often it is contributed by patrons of the school. Those children whose parents do not yet understand the value of milk are encouraged to bring apples, thereby strengthening the fruit habit. Other children whose parents still prefer that their children should not eat between meals may at least rest at this time, with their heads forward on the desk and their eyes closed. Special Health Classes. IV. Our health teaching in every school should include the various elements we have mentioned, finding out the child's physical condi- tion by weighing, and the physical examination by school physi- cians, follow-up work by school nurses, regular daily teaching of health habits, and mid-morning luncheons for nutritional and edu- cational purposes. But after this has been done we shall find some children who have not brought their weight up within the margin of safety. These children must have special attention. This is not the big thing in health education; it is only a part of the work designed for those who are not able to gain and do not respond to the regular methods already mentioned. It is more intensive work for the few who need it. The greatest work is the improvement of the health of all. In every school system there should be one or more of these special health classes. Where the school department can not assume the management of these health classes there can always be found in every communitv philanthropic people, or the Red Cross, or some other fine-spirited organization, which will come to the rescue of this group of children by giving them a chance to be put under the influence of scientific study, proper feeding, and special rest, and thereby saved for greater happiness and efficiency. An admirable outline for conducting such special health classes was suggested in "Commonhealth," published by the Massachusetts Department of Public Health. 39 HEALTH TEACHING. AN OUTLINE FOE NUTEITION CLASSES. Margery M. Smith^ Director^ Dietetic Bureau, Boston, Mass, The aim of nutrition class work with children is to establish good health habits. Methods vary, but at present there seem to be two distinct types of nutrition classes. One of these emphasizes the relation of food to health through the preparation of foods essential for growing children. Other health habits may or may not be considered. This type of class offers possibilities for the home-economics work in our public schools, and is also effective among children of foreign nationalities. The second type of nutrition class emphasizes other health habits as well as food habits, and without any preparation of food. Through friendly group competition individual children are stimulated to improve poor habits and to continue right habits of living. This latter type of class is adapted to larger groups of children than is the first, since it may be conducted with very little equipment, as suggested in the following outline : Essential equipment. A pair of scales. Measuring rod or tape. Weight for height and age tahles. Individual weight charts. Individual records of physical examination and social history. Stars of several colors. Chairs or benches. Wall space with wire for hanging charts. Paper clips. Table. Blackboard. Crayon. DesiraMe additional equipment. Sink Avith running water. Soap. Scrubbing brushes. Individual towels. Suggestions. Scales tested frequently to insure accurate weighing. A measuring rod on the scales, or a tape measure pasted on the wall. Weight tables and record sheets obtained from Child Health Organization, New York City ; Bureau of Education, Depart- ment of Interior, Washington, D. C. Sample weight chart : (See illustration.) Different colored stars given for a gain or loss in weight, with a gold star for three successive gains. Chairs properly constructed for children's use. Washing hands a part of each lesson. 40 HEALTH TEACHING. Graphio and illustrative material. Booklets. Charts. Food slides. Plays. Posters. Rhymes. Stories. Food exhibits. Menu books for a week. Printed recipes on mounted cards. Tags for recording weight. Material prepared by children themselves or obtained from Child Health Organiza- tion, New York City ; Association for Improving the Condition of the Poor, New York City ; Antituberculosis League, Boston, Mass. ; New England Food and Dairy Council, Boston, Mass. ; Massachu- setts Department of Public Health, State House, Boston, Mass. Colored magazine advertisements for health posters. A basket of real fruit or of vegetables. Daily food habits learned through menu book, kept by children. Recipe taken home weekly by each child for mother to try. To interest parents in gain or loss in weight. Preliminary steps. Home visit. Physical examination of children. Special directions from doctor noted. Routine class work. First meeting : Height measured. Average weight for age calculated. Charts made. Each successive meeting : Weights taken and recorded on charts. Exhibit and study of individual charts. Health talk- One good food habit. One other health habit. Conferences with mothers present. Follow-up work in homes. Value of nutrition class explained to mothers. Retarding physical defects corrected, if pos- sible, before first lesson. Average weight line probably raised at end of three months by increased height. Interest stimulated through group rivalry and through discussions of gains and losses in weight. With younger children the play instinct is usually so strong that a successful appeal to them can be made to improve their health habits under the guise of learning the rules of the splendid game of health. Each of the following habits is considered a rule of the game : Rules of the health game. Cleanliness : Hands — Always wash your hands be- fore eating. Teeth — Brush your teeth at least twice a day. Bathing — Take once a week. full bath more than Suggestions. Actual washing of hands when possible, or pictures of children washing their hands. A mock toothbrush drill. Distribution of tooth-paste samples and printed instruc- tions on the home care of the teeth. Pictures and rhymes in A Child's Book of the Teeth, published by World Book Co., Yonkers-on-Hudson, N. Y. Suggestions made applicable to homes with no bathtub or running water, as well as those with bathing facilities. 41 HEALTH TEACHING. Bowel movement : At least one bowel movement a day is necessary, preferably in the morning, after breakfast. Regular exercise : Take some regular exercise out of doors every day. Rest: Rest a while each day. Sleep long hours at night, with windows open. Posture : Sit straight. Stand straight. Go straight. Breathing : Practice regular, deep breathing. Food: Regular meals — Eat three regular meals a day. Chewing — Eat slowly. Chew your food well. Food likes and dislikes — Learn to like all good, nourishing foods. Milk — Take at least a pint of good, clean milk a day. Vegetables — Eat at least one vegetable besides potato every day. Potatoes, root vegetables, and leafy vegetables all necessary. Fruit — Eat some fruit every day if possible. A comparison of fresh and dried fruits. Cereals and bread — Eat plenty of bread or cereal at each meal. Eggs — Eat at least four eggs a week. Exercise in form of both work and play — doing errands, carrying wood, coasting, and playing ball. Forms of quiet recreation for both girls and boys — reading, sewing, and games. Food suggestions should be influenced by family incomes. Importance of breakfast. Mid-morning or afternoon luncheon. Story of tortoise and hare A chewing lesson with plain cookies or sim- ple sandwiches. Story of child who did not like proper food. Child Health Alphabet; Child Health Or- ganization ; milk fairy story ; food charts, Nos. 2 and 3, Association for Improving the Condition of the Poor. Taking milk through a straw or from a new cup. A basket of vegetables. Chart showing leafy vegetables. Stories about the vegetable family. A basket of fruit. Nature's sugar bowls the best kind. Chart showing relative value of home- cooked and ready-to-eat cereals. Whole wheat and oatmeal breads especially emphasized. Eggs with milk, vegetables, and cereals in combination dishes. Water — Drink at least six glasses of water a day. Review of food rules. Eat milk, vegetables, fruit, and cereals every day. Take eggs occasionally. Meat and fish are not necessary, but may he used sparingly. Have a substantial breakfast, a hearty dinner, and a light supper. 42 HEALTH TEACHING. WEiGirr cjfA£r of maj^k bj^owm AGE. f£KSS. 6 MO J. HEIGIfT. S£dlJr. — 'AVEHAGE WEIGJTT. Cr L£J. fin — -ACTUAL WEIGIfT. CO L3S. M J(^ ^^ ?& 1 2 3 4 J ^ 7 6 S> JO II 12 TIME m WESKJ, Food Cldsses, V. Added to this work will come for the seventh and eighth grades the peculiar opportunity of the domestic-science teacher in classes formerly called " cooking classes," but now in some places called " food classes," whose aim is to teach grammar-school boys and girls a knowledge of their own physical condition as revealed by the rela- tion of their weight to height, a knowledge of the kinds of food children should eat, and a knowledge of how to buy and prepare that 43 flEALTH TEACHING. food. This work also includes the care of younger brothers and sisters along the same lines, and special attention to curing consti- pation through diet. In food classes where these ideals have been prominent the response has been most encouraging. The Physical Director, VI. Lastly, we come to the unique opportunity of the physical di- rector. Some physical directors have already realized that their work is an important part of the health program and are much interested in the general health of the children as well as in pre- scribing exercises and giving occasional attention to posture. He should also be equipped to deal with the question of proper school furniture. We are looking forward to the time when physical directors will all understand that they are responsible for the development of health habits as well as for the training in certain physical activities, responsible for such excellent habits as they demand when they are training a team. Physical directors can do work hitherto un- dreamed of in training both teachers and children in a program that counts for health in a broad way. The physical director at all stages of the child's life should encourage a happy, joyful interest in playful physical activity, which is one of the fundamentals of healthy living, and should stimulate the glorious achievement as far as possible of perfect physical condition. The Work is PlariMed for Three Groups^ not for each Grade. Because of the generally chaotic and experimental nature of the health teaching throughout the grades and the vital need of adjust- ing the teaching to the needs of the individual children no attempt is made here to outline the work for each grade. Some general sug- gestions are given for groups of the grades, and the various methods and devices that have been successful in particular grades are pre- sented with considerable detail. The work will be considered under three different headings: (1) Kindergarten through third grade; (2) fourth grade through sixth grade; and (3) seventh grade, eighth grade, and last year of the junior high school. 44 HEALTH TEACHING. Psychology of Healtli Teaching in the Early Elementary Grades Deals with Playful Spirit. The child on entering school has little concern for matters pertaining to health. He lives largely in a world of the present, with its keen joys and equally viA'id sorrows. The goals to be attained are the goals of play. Health activities and interests do have a real place in his life to the extent that they may become a part of his world in Avhich fancy, imagination, and action predominate. It is a simple thing to tell a child that he ought to drink milk and the reasons why, and to get him to reproduce these facts verbally; it is quite a different matter to get those facts to fuse with his emo- tional life and express themselves through the channels of action and habit. The mere correct repetition of words often has little to do with meaning. It is a fundamental principle of educational psychology that a thing takes on meaning through the reactions we make to it. Let us illustrate with teaching a child to drink milk : If we can asso- ciate the drinking of milk with many responses, interesting playful reactions, we shall not onl}^ get the right habits involved but those habits will take on a deeper and deeper meaning with emotional coloring. The child who is not only told that he ought to drink milk and why. but begins actually to drink milk and then uses his creative fancy in making health rhymes about milk, and composing and sing- ing songs about milk, writing compositions, doing construction work, reading, and dramatizing with the drinking of milk as his central idea, begins to have an attitude amounting to a conviction that the drinking of milk is vitally important. These varied reactions take on an added significance in the child's life when they are also coupled with the idea of regular gaining in weight, which is rapidly becom- ing one of the slogans of many progressive schoolrooms. It is important for every teacher and school principal and super- intendent to remember that real health education can not be secured through the usual mechanical processes so common in the teaching of physiology. The teaching must be ^dtalizecl, must be related to children's interests. The starting point of such vitalizing in school systems must be with the school superintendent or school principal, in close cooperation with an efficient board of health, and with the parents of the children. Let that superintendent or school princi- pal become convinced that actual achievements in health are funda- 45 HEALTH TEACHING. mental and are equal to, if not superior to, the advancement made in the traditional school subjects. Let them impress this upon their teachers and the health program will begin to move forward and to have meaning and power. Let the teacher become filled with the idea and it will spread like a contagion among her pupils. The Work foi^ the Early Elementary Group. How can the child's beginning days of school life be used to inten- sify and give greater significance to health habits already begun in the home? How can the school program supply the right kind of health teaching to those children whose homes are inadequate along these lines ? Habits take time — a long time. Wliat is begun in the home, in the kindergarten, may not function until the child is in the third or fourth grade, or even higher ; but faith and work must be persistent, attack must be varied, and many opportunities must be furnished for the children to use the ideas with which their minds and hearts have been filled. There are many such opportunities in the daily life in the primary grades. The Program. The following program, part of which has been explained in detail on pages 34-44, constitutes the essential elements for work in the kindergarten and first three grades, and an understanding of the application of each agency to her needs marks the efficiency of the teacher : I. Measuring and weighing. II. Cooperation from the home, the family physician, the attendance depart- ment, school physician, and nurse where such services are furnished. III. Teaching health habits. Rules of the game. 1. A full bath more than once a week. 2. Brushing the teeth at least once every day. 3. Sleeping long hours with windows open, 4. Drinking as much milk as possible, but no coffee or tea. 5. Eating some vegetables or fruit every day. 46 HEALTH TEACHING. 6. Drinking at least four glasses of water a day. 7. Playing part of every day out of doors. 8. A bowel movement every morning. IV. School luncli for educational and nutritional purposes. V. Special health classes for seriously underweight children. VI. Cooperation from physical director, if one is available. VII. Expression in school work through songs, posters, games, languages, drama- tization, drawing, and construction work. Weighing and Measuring. All little children are naturally interested in everything that con- cerns themselves personally. They take a keen interest in their own height and weight, especially Avhen it is a part of the school game. The health habits to be taught are suggested by the Rules of the Game. All should be taught and especially stressed, because all are needed by all children. The best teachers make this whole question of measuring, weighing, and gaining a recreational part of the school work. It is all a game; it appeals to the play instinct. In the sec- ond and third grades special drives may be made on some one habit when needed. In spite of difficulties, primary teachers must secure tlie help of the school doctor and nurse when possible. One second-grade teacher makes these suggestions for weighing day : Weighing of children must be made a pleasurable tine. Joke with them about it a day or two before weighing day. Take time, two or three days, to prepare for it. Tell them to eat extra and get more sleep than usual, so they will weigh more. Make a gala day of it. Teacher must be weighed, too. Each child who gets up to normal ^Axight receives a gold star. Those who do gain are questioned by those who do not gain, and the children are interested to find out why some do gain and the reasons why those who are ahead of the game are up to weight. Daily Inspection. In the checking up of health habits the daily inspection must play an important part. This will include clean hands and clean nails, clean faces, clean teeth, clean ears, clean noses, clean handkerchief, clean clothes, and reports concerning the personal baths. The carry- ing out of this inspection depends upon the originality and initiative of the teachers. It depends upon their ability to hand over to their children all the responsibility of which they are capable in cooper- ating with the teacher in securing clean companions. 47 HEALTH TEACHING. Sometimes it may be done by rows, one child in each row having charge of the children. That child may wear a Red Cross on his arm, or a cap. These badges may be made in the drawing period. This child only expresses his disapproval to the children. If there is need of anything else, the inspector calls the teacher. After such an inspection there is a general cleaning-up period. This may some- times be anticipated before school in the morning by having all the children who come to school with dirty hands wash them before school. This inspection must be made pleasurable, not painful. Songs may be sung while the inspection is going on. The children them- selves may make rhymes, set to music with which they are familiar, to accompany the inspections. Let there be a corner to which the children may retire to clean their nails. Some teachers furnish toothpicks for this purpose. Soap and water and towels in the schoolroom are excellent imme- diate aids to cleanliness. The vast majority of schools in America have not yet appreciated the need of having soap, water, and toAvels in the schoolroom. Many cases need the help of the school nurse or visits to the home by the teacher, unpleasant though these visits may sometimes be. The aim of class inspection in these grades is to encourage the children and help them to keep clean, not for the sake of keeping- individual records of their shortcomings. In the third grade a class record might be kept of the number of pupils who successfully pass inspection. The same principles for inspection follow through the kinder- garten and first three grades. The work must have variety according to the good sense, the imagination, and originality of the teacher. She can make a game of it; she can have a slogan from month to month. " Down with the Grimy joes " is a good one. GRIMYJOES SONG. (To the tune of " Chop Down the Christmas Trees.") We can beat the Grimyjoes ! We stepped right on their toes ! We made them fall and bump their nose ! Down with the Grimyjoes! 48 HEALTH TEACHING. s ERECT THE WAY TO STAND TO B£ A SaDlER IN mV LAND. A cut-out picture and a printed verse, IS FOR m . IN EVfRY CHILD'S \ HWI?T. ^ (N KEEPING GOOD HEALTH IT pim A child can color posters charmingly, 44807°— 21 4 49 HEALTH TEACHING. Much variety is possible in this morning inspection, so that it shall not lose its power of appeal. The most important thing is that the teacher shall believe in its necessity as a strong influence in health teaching. We purpose in this plan to show how the subject matter of the different health habits can be used to illuminate the regular school subjects. The material suggested is a means of vitalizing them as well as a means of teaching health. Health Material in Other School Suhjects. Let us now turn our attention to the work of the child in drawing, language, stories, songs, games, story plays, number Avork, and other subjects that can help to establish health habits through motor activities. There will follow illustrations of vital work that has been done Avhere this kind of teaching is functioning in the lives of the children. This is a class exercise by second-grade children. No matter how crude the result, if it is the child's own best work, it is a means of securing his interest and cooperation through his personal accomplishment. ^^sJS?^ /I Before I drank milk. After I drank milk, 50 HEALTH TEACHING. ^ r r-J ^7=3 r, 1 / \ \ L ; f 5 \ ) -IJ / i. ! i 1 1 r/iin plus milk equals fat Before he has learned to write, or spell, he can do this work, for he can copy with a rubber sign and price marker what the teacher has written. He can continue this work in the second-grade after he is able to Avrite, and can make very effective alphabet rhyme and story books. Opportunities for paper cutting as illustration of health ideas are many and varied. They give much possibility for humorous ex- pression. Surely Bob who cut and mounted the figures " Before T Drank Milk" and "After I Drank Milk" understood and chuckled over the contrast. A booklet illustrated with free-hand paper cutting and colored pictures was made in one school as a class exercise. From this the following is taken : One, two. Milk's good for you ! Three, four. Play out of doors. Five, six. Bread nice and thick. Seven, eight. Stand up straight. Nine, ten. Eggs from the hen. Eleven, twelve. Brush your teeth well. And so on to — Nineteen, twenty. Healthy children are plenty. 51 HEALTH TEACHING. ^riVg #C QriUiy 1 " Take a bath every day Drive the Grimyjoes away !" This picture of the little girl sucking her fingers was used very effectively to break one little second-grade girl of that habit. The picture made her so uncomfortable it was hard to induce her to do the printing on it : " Do you do this ? " 52 HEALTH TEACHING. By way of warning, 53 HEALTH TEACHING. The posters in the third grade may be very beautiful, artistic in their arrangement, with effective slogans worked out in the language classes. Some of these problems require weeks for their accomplish- ment, but there is no hurry. A variety of the combination of the study of the alphabet, art work, writing, printing, and language work can be seen in pictures Nos. 2, 3, 4, and 5, illustrations of work from the first and second grades. In each case a class book was made, a different child con- tributing each page. The rhymes were made in language class as a class exercise. The whole book was planned as a class problem, all cooperating in the illustrations and the planning of the whole, different pages worked out by different children. Colored pictures added greatly to the beauty of the book. Art principles are applied in the arrangement of the page, the placing of the illustrations, the margins, and colored margin lines. The accomplishment involves a successful combina- tion of art, language, and motor activities. Original Rhymes, an.d Rhymes Based on Mother Goose. Although some people consider this use of Mother Goose rhymes a« desecration, the rhymes furnish inspiration to children to make simi- lar ones. Only a few illustrations can be given out of a wealth of material at hand, but they will be suggestive to the real teachers who can understand and who are eager for help. Peter, Peter, Orange Eater, Every day your smile grows sweeter. Mary, Mary, quite contrary, How does your garden grow? Carrots and lettuce, spinach and peas, Green vegetables, all in a row. New rhymes can be made by individual children or as a class exercise, based on the first line of some familiar rhyme ; or original rhymes can be made even by first-grade children. See the illustra- tions on pages 58 and 59. 54 HEALTH TEACHING. Fruit eating praised in original rhyme. 55 HEALTH TEACHING. -'$'. 'i '^^^^ (Lr\i, !ia.,nj, (|Lt)te coyffmry, i Hoy/ dots \ioiir d^aA-der) ^row ' Ldrrois and lettuce ^ spimcli and peas^ ureen ve^efdhk^ all r/i a t^ow: With apologies to Mother Goose. 56 HEALTH TEACHING. Health Rhymes. Tony Toothbrush keeps our teeth White and smooth and clean ; If we use him after meals, How pleasant it does seem ! Old Mother Goose said, " What is the use To fly on a broom through the sky? " Well, I know I shall see Who's in bedy early, And if not, I can find out why. Songs. In preparation for the milk luncheon in one first grade, two children stand before the class and sing : Come for your milk, Come for your milk, Oh, don't you hear me sing? Come for your milk, Come for your milk. You hear me sing to-day. (To tune of "Cherries Are Ripe," Progressive Music Reader.) The children respond to the invitation, stand in a circle, and are served. Then each child tells what he is drinking in his milk that morning. It may be sunshine, rosy cheeks, smartness, height, fat- ness, or quietness. Qualities the child most needs are sometimes sug- gested by the teacher or his mates. Other health songs follow: What shall we do when it comes Uinch time. Comes lunch time, comes lunch time? What shall we do when it comes lunch time. In our school each day? We shall have some crackers and milk, Crackers and milk, crackers and milk, We shall have some crackers and milk, In our school each day. (To tune of " What Shall We do When We all go Out? " — rrogressive Music Reader.) HEALTH TEACHING. ut tdito^ ^^ Til tet %Q H ok/ Ub^r ^ry St) i\fs ^^y A A ft Pu/Zing familiar rhythm to a new use. 58 HEALTH TEACHING. txdi__ 59 HEALTH TEACHING. «i»»»!l«' 1 CA ^< on '^rm We sing of the milk, That is best for us to drink, We do, Yes, we do, We do. For milk makes us strong, Makes us happy, Makes us think, That's true, very true, quite true. There 're red cheeks and health, And magic strong. In every cup we drink. And then comes the craclcer That we need, So we boys and girls all think. (To tune of " We Sing of the Day that is Best of all the Year.") A writing lesson with a beautiful slant. Come ! Come ! Come ! Come on and get your milk now, Come let's race, To see who grows the faster. (To tune of " Bow-Wow-Wow.") Weighing song for Grades I and II : Hurrah ! Hurrah ! weighing day is coming, Eat ! Eat ! hear the fairies call, Sleep ! Sleep ! see the children growing. Gain ! Gain ! forward soldiers all ! (To tune of " Marching Song." p. 32 — " Songs of the Child World." Riley & Gaynor, No. 1.) Representations of Weiglit Records. The weight facts seem to have a fascination for the children. They like to record them in many ways. Ladders, thermometers, and graphs can be worked out. 60 HEALTH TEACHING. Vegetable Charts. Many children have to learn to eat vegetables. One of the great aims of health teaching in the grades is to make the eating of vegetables popular. In Grade III an artistically arranged border of brightly colored vegetables from seed catalogues can be placed around the room. One device that was used in a third grade was an illustrated vegetable chart. The object in each case was to keep the record of the number of children who had eaten each vegetable each day. The vegetable, excluding the potato, that secured the largest number of eaters won the race for that week and became the vegetable hero. The ultimate object of the vegetable chart is to see at the end of a certain time the number of vegetables each child has learned to eat. /^ TutsAj WWntiAj rnW«j »ii«i<.j s- ^ ^ Z. z. ^HOistlie<^inner? ^ ■/¥ If '^ to z-o /o The interest in eating vegetables and fruit may be intensified by personifying the various vegetables and the curious pranks they play. 61 HEALTH TEACHING. The following rhymes were written by third-grade children : If we eat Billy Beet, He will taste nice and sweet. Peter Parsnip, you and I Will be friends by and by. Danny Prune, when on a spoon, Looks ugly, brown, and fat. But when we taste we then make haste, To eat him, just like that ! Charlie Carrot likes to eat. Iron from the ground. If we eat him, we shall be Big and strong and round. Scrapbooks. During the second and third years all the health work might be cen- tered around the making of a scrapbook to contain pictures illustrat- ing health habits, with appropriate messages underneath. The pic- tures they gather for their individual scrapbooks show keen interest on the part of the children. In one book the child selected attractive colored pictures illustrating a good breakfast, dinner, and supper. Under each combination was written an appropriate suggestion: "A good breakfast for a good little girl " ; " This dinner will make me strong " ; " Do you eat a good supper every night " ? These were exceedingly attractive colored pic- tures. In addition to the pictures illustrating the health habits and the proper kinds of meals to eat, was his weight record for the year and a graph showing his increase in weight month by month, also the songs which the children and the teacher composed to familiar tunes. By the end of the year the book will be a real personal treasure and will contain much health stimulus, with its blue covers and its highly colored picture of children at play on the front page. Each child in the third grade also made a scrapbook in which the descriptions and rhymes almost rivaled the colored pictures in interest. In the beginning of the book the health rules were written. A baby in his bath begs, " Please don't take me out yet ! " A child who is being measured asks eagerly, "Am I as tall as Jim ? " Of a roly-poly child the story is, " No wonder she looks well, she drinks milk ! " 62 HEALTH TEACHING. The following is an illustration of a third-grade song : (Sing to the tune of " Carolina Sunshine.") Be sure to brush j-our teeth in the morning, Be sure to brush again at night, Then when boys and girls are smiling, Teeth are shining bright. No one wants to have a toothache. So, of course, we must try ; All of us must keep on brushing, You, and you, and I. Games. These games were worked out on the summer playground and were described by Agnes Early in the Commonhealth. The children made some games themselves. These were made under the direction of the handwork supervisor as part of the handwork program. The younger children cut out pictures from magazines of foods good for them and pasted them on cards. This game was called Foods, and incidentally it taught the player what foods were good for him. The game was played like Authors. The older girls printed the names of a group of foods at the top of a card, such as puddings. The younger children cut out and pasted a picture of a pudding good for children underneath the title. Underneath this the older children printed the names of three kinds which would be suitable for all children. For example, under puddings they had rice, custard, and junket. These three cards made a book, and the one who got the most books won the game. There were 30 cards in the set, and when five played the game was most interesting. Another game, also developed on the playground, was one played like Old Maid. It was called Trouble Imps, and the Trouble Imps would get you if you didn't watch out. These imps were on a card similar to the Old Maid card and consisted of bad habits, such as the tea pot, the frying pan, all-day suckers, late hours, etc. The other cards had pictures of fruits and vegetables good for children. Again they printed the names. They had Letty Lettuce, Parson Parsnips. Auntie Apple, etc., with the words " Eat me," and underneath the picture good methods for preparing them before they were eaten. When they tired of quiet games the children often enjoyed a snappy game of Beast, Bird, or Fish, only they had to think of Fruit. Cereal, or Vegetable before they counted 10. And so the game was played with the idea of spontaneous play, which is the only practical playground method. 63 HEALTH TEACHING. Origina l Sto ries^ Mary Ann awoke with the The ^ ij^ were si n/7;lng in the First sh'^ put on her and her M Then she washed her picked up her / ]r and her and her and cleaned her For breakfast she had a baked O a bowl of "^ ^—^ jMmmm After breakfast she went to lie r face looked like this X rik- ^\ Similar stories can be written and illustrated by the children con- cerning other phases of the child's day. 64 HEALTH TEACHING. More health in writing. 44807°— 21 5 65 HEALTH TEACHING. t: ~n A dumb show with obvious significance. A fruitful reminder, 66 HEALTH TEACHING. Grades IV-VI. — Psycholo(/ij of Health Teachinr/ in the Jliddh Grades Deals With Life of Real Children. In those schools where the pedagogy of the subject is being seri- ously studied there has been some progress along the lines of effective health teaching, but the most original and inspiring plan^' have been developed by the teachers of the lower grades. It is important that the middle-grade teachers make themselves very familiar with the work accomplished in the formation of health habits in the primary grades and continue along the same lines, but necessarily from a different angle. In the middle grades the fairy story makes less appeal, but there is a greater interest in stories of real children. Such stories in the fourth and fifth grades may be followed in the sixth grade by the stories of great health heroes like Pasteur, Reed, Gorgas, Dr. Grenfe], and others, and simple narrations of the dramatic achievements in modern preventive medicine and sanitation. In these grades, as in all the grades, it is essential to remember that the self- activity of the children must be aroused. They must get beliefs strongly tinged with emotions which help them to estab- lish more firmly the habits already begun in the primary grades. Teachers must present the work in new ways in these grades so that children will not become deaf to the appeal. There is danger that they may become as bored by the Rules of the Game as they some- times are by the oft-repeated stories of our national heroes. The complete program for health work is here repeated to make the relations clear. Program for health work. I. Measuring and weighing, II. Cooperation from tlie liome, tlie family physician, and from the attendance department, school physician, and nurse, where such services are fur- nished. Ill, Teaching health habits. EL-XES OF THE GAME. 1. A full bath more than once a week. 2. Brushing the teeth at least once every day. 3. Sleeping long hours with windows open, 4. Drinking as much milk as possible, but no coffee or tea, 5. Eating some vegetables or fruit every day. 6. Drinking at least four glasses of water a day, 7. Playing part of every day out of doors. 8. A bowel movement every morning. 67 HEALTH TEACHING. IV. School lunch for educational and nutritional purposes, V. Special health classes for seriously underweight children. VI. Cooperation from physical director, if one is available. VII. Expression in school work through songs, posters, games, language, dramatization, drawing, and construction work. Let the teacher take account of the habits that can be counted upon as akeady formed, and stress those that need particular attention, watching especially for lapses that always occur in children of these ages. Regular bedtime, eating vegetables, and drinking milk need to be checked up with great care. Dr. Thomas T>. Wood gives the following advice about sleep : " Get as many hours in bed each night as this table indicates for your age. Keep windows in bedroom well open." Hours of sleep for different ages. Year of age. Hours of sleep. 5 to 6 13 6 to 8 12 8 to 10 lU 10 to 12 • 11 12 to 14 lOi 14 to 16 10 16 to 18 9^ Weighing and Measuring. Since the weighing and measuring is so important as an index to health and improvement in health, it should continue regularly through all these grades. As in the primary grades the children should be measured twice each year; in September, and possibly in March; and should be weighed each month, and the parents should be notified of the results. Each child's individual health work will center around his weighing and measuring. It can not be made too emphatic that mere weighing and measuring will amount to little or nothing unless it is connected with the definite needs of the children. The time for weighing should be an intensely interesting moment in the health teaching of the month. Philip steps upon the scales. The weighing reveals the fact that he has gained IJ pounds during the last month. Two methods of procedure are now open to the teacher. She can simply record this result and say, " Next ! " to the child who is waiting, and Philip can go back indifferent to his classroom. On the other hand, she can make his gain in weight a HEALTH TEACHING. point of vital contact between what they have been studying and what he has been doing. Now is the time to get some serious reflec- tion on the health teaching of the month. Philip is asked to tell why he thinks it happened. It may be that he has had his milk every day, maybe he has eaten more cereal, or maybe he has had more sleep. His success stimulates not only Philip to greater effort, but it will have a direct effect upon the other children. The teacher finds that Barbara has not gained as they hoped she would. The child must not be discouraged, but she must be helped to realize, if possible, why she has not gained. She may reveal the fact that she has not been drinking her milk, or that she has not been going to bed early, or possibly she has had a cold. All these may be explanations for her failure to gain. As the children may learn from the gain they can also be helped to gain from the failure. Barbara really wants to play the game ; she has been careless but now she sees that she must work to win. She will work and she will win! Girls of this age have an increasing interest in their appearance. Boys are tremendously anxious for growth and muscular develop- ment. These interests may be used to spur pupils on. The}^ may sometimes be told how much better they are looking. It is never de- sirable to tell children who have not gained that they are not im- proving in their looks, or that they are not looking well. The positive results of good health should always be stressed and the appearance of ill health ignored. A good health slogan at this time might be WATCH US GAIN! Careful treatment must be given to the children who have not gained. It is very important that children who have failed to gain, or who are seriously overweight, should be treated tactfully and wisely. When the pupils return to the classroom after being weighed, let there be rejoicing. Let all children who are within the margin of safety stand. Comment enthusiastically upon their improved physi- cal appearance. When those pupils are seated, ask for all who have gained this last month to stand. This is an occasion for rejoicing for the whole room. Failure to gain on the part of the few is usually understood bv the teacher and should be ignored at this time. 69 HEALTH TEACHING. At this time a graph representing the accumulated gain for the whole room for the month can be worked out in an arithmetic class and later placed upon the board. Competition can be stimulated with some other room of the same grade. Now the teacher has discovered where she must place her emphasis in her teaching of hygiene for the coming month. It may be in arousing them to a keener responsibility through a new approach in teaching health habits. It may be through some new device for stimulating interest in the daily inspection and individual recording of results. Health Habits. Although the health habits begun in the home before entering school have been practiced in the lower grades, they have not yet become automatic. The results of our teaching now will not be so spon- taneous and so spectacular. Indeed, the teacher in the middle grades will often be disappointed and feel that her health teaching is not bringing results, but she is helping to establish more firmly the habits begun in the earlier grades. We must still use posters, rhymes, and songs, but this work will now express the more reflective type of mind. Not only the choice of the picture but the words underneath will portray a deeper insight. A child V beliefs must be expressed not only on paper but in his own life. As educational material for other school subjects this kind of work is valuable because it furnishes opportunity for steady improvement in technique and final results. The newer forms of expression that we find in these grades are original stories, plays, written and dramatized reports on actual conditions and ideal conditions in their school and their town, and discussions of personal experiences in these health adventures. l7ispection. The teachers should realize that any kind of teaching, no matter how interesting, will fail of its purpose unless there is follow-up work to see that children are really practicing what they have been taught. Although they have been practicing the Rules of the Game in the lower grades, some of these have not been made automatic, and in some of them, as in the case of cleanliness, eternal vigilance will be needed. A higher excellence must be demanded. It is at this point HEALTH TEACHING. that daily inspection becomes invaluable. Just as drill is necessary in teaching fundamental subjects, so daily inspection is the drill work in the teaching of health habits. We should look for results each day. While frequent inspection is necessary to induce children to pay proper attention to personal cleanliness, yet the teacher should shift the responsibility to the children themselves as soon as they can assume it. Class inspection should be made as soon as possible less frequent and with less regularity. This inspection may be made a kind of military proceeding with captains for each row. The ingenuity of the teacher has its oppor- tunity in preventing this inspection from becoming monotonous and mechanical. An informal health club may be formed to take this daity inspection entirely out of the hands of the teacher. A splendid stimulus for the accomplishment of results in these middle grades is the cooperation of the principal or the superintendent in occasional inspections. Excellence of results in forming health hab- its will be greatly furthered when the principal of the building or the superintendent of the town will take as much personal interest in the formation of health habits of the children as he does in their arithmetic and their spelling. His occasional inspection of the chil- dren and his commendation of clean hands, clean nails, clean teeth, and good general appearance of the children will be a great help to the teacher and also an inspiration to the children. A request for reports to be sent to the office will not accomplish these results. Personal interest and influence are necessary. This, of course, takes for granted the understanding of this great problem by the prin- cipal and his hearty cooperation in the movement. The Modern Health Crusade has given suggestions which many teachers will find helpful in their daily inspection, but the teacher must always fit her devices to suit the special needs of her children as she sees them. Mi d-Mo rn ing Luncli. The question of a mid-morning lunch needs a little stimulus in these grades, for many people have believed that milk was a food only for little children. The special point was made in the primary grades HEALTH TEACHING. that the mid-morning lunch of whole milk was not only a nutritional but an educational matter, for the purpose of teaching boys and girls to use milk more generally as a food. It is important that children of the fourth, fifth, and sixth grades should continue to realize its value, and when the teacher appreciates this importance and makes the right kind of appeal the mid-morning lunch takes its proper place in the health program of the middle grades. Time. The question of time for this work may be answered in two ways. In all programs a certain amount of the time is assigned for the teaching of hygiene and physiology. Unfortunately it often happens that this time is used in various ways for the traditional school sub- jects. This invariably happens when the school superintendent or principal or teacher fails to realize the importance of health teaching. When the time comes when such definite results are re- quired in the teaching of hygiene as are now required in the regular school subjects, then hygiene will be taught in the time assigned to it. One day each week let the material in language work be health material. Let at least one health problem a month be worked out in drawing, one health poster a month or scrapbook for definite assign- We are on our way to the top ! Heavy square incloses ments. There may also be voluntary work for especially interested and enthusiastic pupils. 72 HEALTH TEACHING. Supplementary reading and incidental discussion of the modern books on hygiene alone will not be effective in forming health habits. There must be personal application and the definite check- ing up of individual results. Besides the response which the child makes in the supplementary reading, there are other reactions which he may make with different material and opportunities so as to vitalize the teaching necessary for his personal needs and interests. Such vitalized material will furnish thought content for many other school problems. The fol- lowing are some suggestions of ways in which health material may be used to illuminate other subjects in the school curriculum in the middle grades and take no extra time : 1. Language^ both oral and written compositions ; " How I Gained," or "Why I Lost," "Milk Lunch for School Children"; re- ports of school and of neighborhood conditions, original stories, plays, rhymes, songs, and slogans. 2. Drawing^ individual graphs for recording height and weight. The drawing lesson can arrange and illustrate health material. 3. Arithmetic^ making menus or ordering meals in a restaurant, in- volving choice of proper foods for children for different meals, with the cost of these meals to be found and reckoned in the arithmetic lesson. We have reached the top We have gone over the top 0^ D Average weight according to age and height in September. 73 HEALTH TEACHING. 4. Scraphooks containing original drawings or colored pictures from advertisements in magazines to illustrate all the health habits — the choice and the arrangement an art problem. 5. Vegetable charts illustrated with pictures from seed catalogues or with colored drawings. ; V r . ^' l^' ^.'. ■\ m' ^ r:\/ f^ \^' A health slogan for a real boy. 74 HEALTH TEACHING. 6. Records of the business transaction in purchasing milk and cradkers for the midmorning lunch for the room or building. T. Graphic presentation on chart or blackboard showing total gain 'y in pounds for whole room month by month. fc. Stirring health songs written for special occasions. % Supplementary reading of interesting health material : Junior Red . Cross Magazine, reports of the work of the Red Cross, and other social agencies found in the daily newspapers. 10. Exhibits to represent the work of the grade, in the corridor or assembty hall. 11. Dramatizing of plays written by the children or suitable ones found elsewhere. 75 HEALTH TEACHING. E^RLY TO BED E4RLY T6 RI5E Health messages gleefully illustrated by children. 76 HEALTH TEACHING. idcuyB^ /^rvcrur /oTVf A class competition in average weight-height. >' B F r S xC- J. A class tally. 77 HEALTfl TEACHING. HEALTH SONGS. HE WOULDN'T USE HIS TOOTH BRUSH. (Published by M. G. Leebrick, Burlington, Iowa.) Little Johnny had a toothbrush, and he hung it on the wall. Morning, noon, and night it hung there, and he used it not at all ; Then one day while at the table, he began to scream and cry, " Oh, my teeth, my teeth, they hurt me, mother dear I know I'll die." So she took him to the dentist, but the dentist shook his head, " Oh, 'tis too bad, too bad, Johnny, you must lose them all," he said, It's too late for little Johnny, but it may not be for you ; Use your toothbrush three times daily, now will you, and you, and you? Written by a teaclier for her children. A VISIT TO THE HEALTH KING. Maud Sullivan. Health Fairy: What a beautiful world this is ! I feel so happy, I think I will go and visit our king and tell him how hard the little earth children are working to make their bodies strong and their minds bright. First Child: Where are you going, little Health Fairy? Health Fairy: I am going to visit our king, to tell him of the good work the little earth children are doing to make their bodies strong and their minds bright. First Child: May I go with you? Health Fairy: Yes. I saw you going to bed early last night, and you slept with your window open. I am glad to have you come with me. Second Child: Where are you going, little Health Fairy? Health Fairy: I am going to visit our king, to tell him of the good work the little earth children are doing to make their bodies strong and their minds bright. Second Child: May I. go with you? HEALTH TEACHING. Health Fairy: Yes. I see you have a clean face and clean hands and nails every day and your hair is nicely combed. I am glad to have you come with us. Third Child: Where are you going, Health Fairy? Health Fairy: I am going to visit our king, to tell him of the good work the little earth children are doing to make their bodies strong and their minds bright. Third Child: May I go too? Health Fairy: Yes. I see you always remember to brush your teeth every morning and night. I am glad to have you come with us. Fourth Child: Where are j^ou going, little Health Fairy? Health Fairy: I am going to visit our king, to tell him of the good w^ork the little earth children are doing to make their bodies strong and their minds bright. Fourth Child: May I go, too? Health Fairy: Yes ; I see you drinking milk every day, both at home and in school. I am glad to have you come. FiUh Child: Where are you going, little Health Fairy? Health Fairy: I am going to visit our king, to tell him of the good work the little earth children are doing to make their bodies strong and their minds bright. Fifth Child: May I go with you? Health Fairy: Yes. I see you are trying to eat the vegetables that your teacher tells you are so good for little boys and girls. I am glad to have you come. Health Fairy: Here we are at the king's palace. Won't you please sing your health song ' I hear you singing every morning in your schoolroom? [Children sing Health Song.] King: Do you hear those little children singing, my queen? Queen: Yes. Let us go out and thank them for the good news they bring to us. King: We thank you, little earth children, for the good news you have brought to us. When you go home please tell the other little children to keep on doing the good work you have just told us about in your song, and always to remember that "The good American tries to gain and keep perfect health." [Children sing Health Song again.] 79 HEALTH TEACHING. HEALTH SONG. (To the tune of '' Cherries Are Ripe," Progressive Music, Book I.) I. Healthy and strong, Happy and bright, We children grow each day, Doing the things. That good health brings In work and rest and play. II. Plenty of sleep, Plenty of play, And drinking milk each day, Face and hands clean and white, Teeth brushed morn and night. We're good Americans ! (Children of Grade IV.) Rhymes made by individual children in a fourth-grade language class. Hurrah for Hyde Four! We are physically strong ! We are mentally awake! We are growing very wise, For our mid-morn lunch we take. Eleanor Savage. Drink Milk. Sister did not drink her milk. Brother drank his glass. When these children get to school. Who will lead the class? Helen Russo. Drink Milk. Bobbie drinks his milk each day, Teddie doesn't, so they say, Bobbie's growing big and tall, Teddie doesn't grow at all. Shirley Somes. 80 HEALTH TEACHING. GOOD HEALTH. A class exercise written hy a teacher, Grace Aiken, for her fourth-fjrade children. Ten children bearing cards on Avhich are inscribed letters spelling " Good Health " stand. Each recites one verse. I wonder what these patriots of long ago would say, If they could see our army, in all its full array? I wonder if they wouldn't laugh, perhaps they'd think it fun. To see us marching by without a sign of sword or gun. But we are strong as strong can be. And we can whip the enemy. You wonder how — well, I will show The way we make our strength to grow. First, every morning when we wake, We at the open window take Three mighty breaths, a one — two — three, It makes us feel, oh, splendidly. Then wash with care, oh, such a lot. You couldn't ever find a spot On any of us when we're through ; But still there's something else to do. Our teeth we brush, round, up and down, As Cho Cho does in New York town ; The clown you've heard them tell about, Who's never known to frown or pout. Then down to breakfast we all go. And sit at table — all just so — Oh, how we eat, oatmeal and eggs, And each for second helping begs ! At last we hurry off to school, For promptness is, of course, our rule; There happy all the livelong day We make of our work merely play. At luncheon vegetables we eat, Bread, butter, milk, and boiled meat; We don't drink tea or coffee, no ! For then we shouldn't stronger grow. At seven we are off to bed. And when at last our prayers are said, We dream of armies great and strong To which Americans belong. 44807°— 21 6 81 HEALTH TEACHING. Don't you suppose those patriots Of long ago would cheer Our Children's Good Health Army, If they were only here? Vegetables Children Have Learned to Eat This Term. [A report made by one class of Grade IV.] Ruth Carrots. Mary Lettuce. Robert Onions, spinach, parsnips. Virginia Spinach, asparagus. Marjorie Lettuce, onions, beets. Gloria^ Carrots, parsnips. Caroline . Asparagus, carrots. John Onions, greens, asparagus, spinach, carrots, parsnips. Walter Onions, carrots. Addra Beets, turnips. Lydia Carrots. Jeremiah Onions. Edward String beans. Ralph Carrots, lettuce. Kenneth Carrots. George Turnips. Ethel Beets. Harold Onions, turnips. Children's Reports on Markets — Grade IV. (Children's work before there was any revision of English.) S 's market is on Summer Street near the South Station. Everything is nice and clean there. The meat is kept in a refriger- ator room. When anybody comes in to buy meat the man will go into the cold room and cut it. The other meat that is out in the store is kept covered in showcases. The vegetables and fruits are always fresh. They are kept covered with nets. This store just opened up. They have a place where they make doughnuts. It is clean. The floor is clean. But the back room is dirty, and they have a lot of flies in there. But outside there is a nice place where the people come to buy. I think these people are sneaky, to have such a dirty back room. There are a grocery store on Howard Avenue. This man does not keep his meat covered. Mr. B keeps his fruit covered. He 82 HEALTH TEACHING. keeps all his pies, cookies, and bread covered. There is not many flies in his store. I think he is a very clean man except his meat. I went into a grocery and saw that the walls Avere dirty. Flies were on the apples, bananas, and potatoes. The wood was all over the floor. They had some of the flour on the floor and coal was on the floor. The glass cases were dirty. The dust was over the things that were in the glass cases. Some of the barrels were uncovered and flies were in them. Cakes were dirty and flies were on them. Pies were dirty. Some of the dust w^ent on them. Candy was dirty, floors were dirty. Floors were not sw^ept. The fruit was all dirty. Flies walked over it. I w^ould not buy in this store. Grades F//, VIII^ and Last Year of the Junior High School. Psychology of Health Teaching in the Upper Grades Deals with Group Interests. The fact that some teachers are getting from grammar-grade chil- dren the response of vigorous interest in personal health proves that success in this subject is the result of the teacher's appreciation of the use of hygiene material in the daily life of the school subjects. The newer health movement, which has gained impetus in the lower grades and has inspired originality on the part of both teachers and pupils, has made less progress in the upper grades. Here in the majority of schools the work seems to be going along the ordinary formal channels of recitation from textbooks. Yet some kind of program of a pr^ical character has been started in various parts of the country. The most suggestive work has been done by those schools that have recognized the peculiar mental characteristics of children of those grades. This is the period of belonging to the group. The individualistic competitive tendency which has been so marked in previous years still exists, but it has become subordinate to another impulse, that of becoming a member of a group. This is the time of team games, like baseball and football. It is also the time when boys form school gangs that may become the terror of neighbor- hoods, or, when properly directed, as in the case of legitimate clubs 83 HEALTH TEACHING. or Boy Scouts, may prove of rare educational value to the boys and of unusual worth to the communities in which they live. The Girl Scouts and the Campfire Girls are similar organizations for the girls. The problem of education at all times is to guide the im- pulses of the children along the lines leading to good citizenship. The most far-seeing educators have realized that this interest in and loyalty to group organization is a tendency with far-reaching possi- bilities if properly directed, for the good citizen is one who func- tions helpfully in the smaller and larger community life of which he is a part. This early adolescent period offers, then, a unique opportunity for training in community life. In many schools where there has been a keen appreciation of this psychological, social, and educational point of view the higher grades have been organized into Civic Clubs. Many of these deal with health problems. In the State of Utah these clubs are called Civic and Health Clubs. In these clubs the health questions have promi- nent consideration. Naturally these clubs differ in various places in their origin, organization, and scope of activities, but they are all essentially alike in their purpose of getting children to organize a social group, elect their own officers, and with the help of the teachers make a study of the narrower community needs, such as the school- room and grounds, and the larger community life of the children, such as the town, city, county. State, and Nation, and to do some- thing through such an organization to solve those problems nearest at hand. Such a procedure when guided by wise teachers insures interest, worthy action, and a certain amount of individual respon- sibility, a fundamental characteristic of good citizenship. Organization of Health Cluhs. As an illustration of a plan of a civics and health club for the upper grades that might be regarded as typical of the best, we quote from a bulletin issued by the State department of education of the State of Utah: I. What are Civics and Health Clubs? Civics and Health Clubs are student organizations for the pupils of junior high schools in which, under wise direction, the members undertake activities in civics and health, in vocational training, and in music and ar€ appreciation, which tend definitely in the direction of such physical fitness, good citizenship, 84 HEALTH TEACHING. vocational efficiency, and leisure-time employment as we now regard as desirable educational objectives for junior high-school pupils. These clubs may be organized in any regularly constituted junior high school or by combining seventh and eighth grades in such schools as retain the old type of organization. The plan can also be adapted to those schools in the State in which grammar grades are combined under one teacher. Any number up to 100 makes a workable group. Where there are more than 100 students two or more groups should be organized, and the element of group competition taken care of. Meetings should be held at least once each week at a time provided for in the weekly program within the regular hours of school work. Evening ses- sions should be held only when desirable to secure the cooperation of the com- munity and stimulate coinmunity interest in the work of the club or the school. II. What Results May Reasonably lie Expected from Work of this Kmdl The club work is based on the recognition of the fact that junior high school pupils are entitled to a different type of training and discipline from that given in the elementary school. Here we must begin the work of developing initia- tive, making the individual feel responsibility for his own conduct, leading him to establish some control of conduct, increasing his responsibilty for the welfare of others. In the matter of personal health it is to be noted that satisfactory health habits have been formed in the elementary schools, but they have not become so automatic that further attention need not be given. In the club w^ork there will be regular checking up on the health habits of the members, the club members assuming this responsibility. III. What Will These Clubs Undertake to Do? The fundamental idea underlying the organization of these clubs is that the best kind of education is education through participation. Students will learn,' to become good citizens by doing the things expected of good citizens. The members of the club will therefore engage in their own organization and the conduct of their own meetings. They will check up on the health habits of members. They will make school and community service in matters pertaining to public health, sanitation, pests, community needs, prevailing types of amuse- ment, vocational possibilities, and other matters of community interest. They will also engage in the study of art appreciation and music appreciation. The emphasis of this year's work could well be directed along the following lines: a. CIVICS. 1. The town beautiful, the school beautiful, the home beautiful. ■ — 2. Public sanitation, 3. Survey of prevailing types of amusement and recreation. 4. Responsibility of the individual and the group in determining types of recreation. 5. Rural sanitary survey as outlined by Dr. H, J. Sears, 6. A clean school contest under direction of Utah Public Health Asso- ciation. 85 HEALTH TEACHING. b. HEALTH. 1. Checking up of health habits of members concerning cleanliness, self-control, practice of health laws, physical exercise. c. APPRECIATION— MUSIC, ART, LITERATURE. 1. Music interpretation ; appreciation of good music ; use of Victrola or other instrument in teaching music appreciation. 2. Art appreciation, through display and explanation of a number of the world's masterpieces of art. 3. Literature — selections of good literature under direction of English teacher. All rural schools in the State will be expected to conduct the rural sanitary survey as outlined by Dr. H. J. Sears, of the University of Utah. All schools of the State will also be expected to participate in the clean-school contest con- ducted under the direction of the Utah Public Health Association. Civic pride and responsibility will be developed in the pupils through their participation in surveys, clean-up campaigns, and other matters of community welfare. The pupils must be made to feel that they are a part of the community, and as such have definite responsibilities to the community. IV. Organisation. The underlying principle in the organization of the clubs should be " Educa- tion through participation." Students should be encouraged at the earliest pos- sible time to assume responsibility and take initiative in the conduct of the club work. The officers of the groups should be those suggested in the consti- tution and by-laws and such other officers as local conditions may make neces- sary. No offices should be created which do not have definite functions to per- form. The organization of Health Clubs at Rochester, N. Y., has been most carefully worked out, and with marked success. Each club, or room, is organized into teams. Wholesome competition between teams and individuals is encouraged. The achievements of individ- uals and groups are based on a system of points. These are the regular questions asked by inspectors daily for which points are given : INSPECTION QUESTIONS. 1. How many have clean faces, ears, neck, and hands to-day? 2. How many have clean and neatly filed finger nails to-day? 3. How many have clean shoes and neat laces to-day? (Face sideways and show shoes in aisle.) 4. How many brushed their teeth last night before going to bed and before coming to school this morning? 5. How many have a clean handkerchief to-day? (Show.) 6. How many present a clean and neat appearance relative to their clothes? (This means neatly combed hair, orderly necktie, ribbons, blouses, and dresses. ) HEALTH TEACHING. 7. How many removed their rubbers at the school entrance and left them with their sweaters (if they wore one) in wardrobe this morning? (A ward- robe inspector may be appointed to help team inspectors in checking tip their inspection.) Note: Every unclean child must wash before beginning class work. Extreme unhygienic cases should be sent home under direction of the principal. (See School Form No. 5 en cleanliness.) HOXOR QLESTIOXS. 8. How many ate breakfast this morning and refrained from drinking tea or coffee? 9. How many slept at least nine hours last night with their windows open? 10. How many played outdoors at least one hour yesterday? (The Boys' and Girls' Recreation Club meetings shall be counted in this question as one hour, whether indoors or out.) Tlie Health Creed. In the earh^ elementary grades the Rules of the Game furnish the goals for the practical health accomplishments. The Health Creed issued by the Massachusetts Board of Health brings to the zeal of the older boys and girls for their physical well- being spiritual meaning and community interest. MY BODY IS THE TEMPLE OF MY SOUL. Therefore: I will keep my body clean within and without ; I will breathe pure air, and I will live in the sunlight ; I will do no act that might endanger the health of others; I will try to learn and practice the rules of healthy living; I will work and rest and play at the right time and in the right way so that my mind will be strong and my body healthy, and so that I shall lead a useful life and be an honor to my parents, to my friends, and to my country. Essentials of the Program. As in the early elementary and middle grades, the teaching in per- sonal hygiene centers around the following program, here given for the third time : I. Measuring and weighing. II. Cooperation from the home, the family physician, the attendance depart- ment, and the school physician and nurse, where such services are furnished. III. Teaching health habits.' 1 Rules of the Game (see p. 46). 87 HEALTH TEACHING. IV. School lunch for educational and nutritional purposes. V. Special health classes for seriously underweight children. VI. Cooperation from physical director, if one is available. VII. Expression in school work through songs, posters, games, language, dramatization, drawing and construction work, and cooking classes. Weighing and Measuring. As in the primary and intermediate grades, the weighing each month should be one of the features of the health work in these upper grades. All the pupils should be interested in the weighing of each one, the increase in weight being a matter of class pride. Individual graphs should be carefully kept in health notebooks. The weighing day comes once a month ; the measuring day twice each year, once in September and once in March. The weighing day should be a dra- matic occasion. It is the testing time for one evidence of health accomplishments during the month. Let the whole class assemble and watch the weighing of each pupil. Have each one as he steps upon the scales hold in his hand his weight card. Before he is weighed let him announce, " I should weigh 97 pounds. Last month I weighed 92 pounds." The teacher sets the scales at 92 pounds. All the children watch to see whether the boy has lost or gained. The teacher adjusts the scales to his exact weight ; then the boy announces, " I weigh 95 pounds. I have gained 3 pounds." He records it on his card. All the children are interested in his accomplishment. As in the middle grades losses in weight can be discussed person- ally with the children and not publicly in class. Many times the children can account for them easily. After all the class is weighed let there be some kind of recogni- tion of the complete class accomplishment in gain in weight for the month. Each pupil will register his gain or loss on his individual graph in his health notebook. The accumulated gain of the entire room may be recorded on a class graph as in the middle grades. Directly following the weighing the cards are sent home that the parents may be notified. At this time of the month, when in- terest is keen in weighing, health material can be used effectively in other subjects, and not continuously throughout the whole month. HEALTH TEACHING. Beauty and Strength. Among girls particularly there is an interest in personal appearance, which frequently becomes one of the most powerful motive forces in their lives. It is strong also in boys, although possibly not out- wardly so marked or so insistent. The appeal to the boys is largely through greater strength and endurance. These attitudes offer a splendid chance to connect personal hygiene with the goals of beauty and strength. Let them know aright the fundamental truth that good health always promotes attractive physical appearance and power in the game of life and the desire to practice the rules of healthy living will naturally follow. Rosy cheeks and sparkling eyes are always preferable to dull eyes and a pale, sallow, or manu- factured complexion. The question of an attractive complexion/ naturally relates itself to the discussion of fresh air, exercise, sleep, food, bathing, digestion, elimination, etc. The cultivation of the spirit of " out-door-mindedness " may suc- ceed in making even proper shoes and warm clothes fashionable. Training for the team. The strong interest in being a member of a team, which prevails at this time, may also be turned to account admirably. A room may be divided into teams or rooms may be pitted against each other. The goal may be that of the greatest increase in weight and the lowest number of absences because of illness. In such a contest the study of the training of an athletic team may be used effectively. The necessity of every member of a college or high-school athletic team taking the best care of his health could be made to stand out promi- nently. In connection with such team play health practice would take on a new and significant interest. Conspicuous among such team requirements are the following : 1. Each member must haA^e plenty of sleep. 2. He must eat plain nourishing food regularly. 3. He must bathe daily. 4. He drinks no tea or coffee. 5. He must not smoke. 6. He must have a movement of the bowels daily. Some boys realize for the first time the real personal value of their health habits in being a member of a team. They know they have to 89 HEALTH TEACHING. be physically fit to play the game. They realize that milk is not just a baby food when they hear that Ty Cobb drinks a quart of milk a day as part of his training, and that each midshipman in the United States Naval Academy drinks a quart of milk daily. Organization of Informational Course. Up to this point we have been considering the functioning of the health work of the upper grades rather than its informational con- tent. The connection should be very close naturally. It is customary in all schools to assign a given amount of time in each of these grades for class work in what is included in the general captions of physi-. ology, hygiene, science, or civics. The name given is unimportant as long as the work functions, but there are often unfortunate associ- ations with particular words. Physiology suggests the old formal dry static instruction which we ought to have outgrown by this time, a kind of instruction which is self-satisfied with the mere acquisition of information. Hygiene is a better word, but does not carry the positive attractive suggestion of health. Whatever these courses are called, it seems desirable to have the word " health " appear. Often the informational content in hygiene is worked into a course in gen- eral science. This is usually unfortunate, because the aims of gen- eral science are often academic, theoretical, unrelated to the every- day life of boys and girls. Knowing rather than doing is too often the conscious or unconsciotis aim of such courses. The union of health with instruction in civics seems to be more appropriate. First of all, hygiene in these upper grades should be a social study rather than a scientific study. Civics as it is now being taught more and / more is directed more emphatically toward social activity and social ' service than ever before. Into such a program health activities nat- urally fall. Whether the informational courses take the name of healthy or civics and health, it is undebatable that information pre- sented should be attractive to the boys and girls, carefully organized i with reference to response, colored with a civic spirit and often find- ing its civic expression in action through some sort of club which has much power of self -direction under the supervision of the teacher.] Physiologi) that Works. Although the work of the upper grades should be dominated by a social and civic attitude, the necessity for the teaching of personal 90 HEALTH TEACHING. h3^giene still remains. It should be remembered also that unless the individual has robust health he can not play his part in com- munity life as he should. During this period of the child's life — possibly in the seventh grade — there is an opportunity to approach personal hygiene, individual health habits, from a different angle. Every child before graduating from the elementary schools should have enough knowledge about the structure and functions of his own body to satisfy his normal curiosity and also to make him more intelligently interested in the care of his own body. This is not a recommendation for the old-style teaching of physiology, which was concerned with the collection of a great mass of facts often having little relation to healthful living. The newer physiology, with a minimum of anatomy, probably ought not to be called physiology, because of the traditional prejudice and weaknesses associated with the name. It needs a different content and more definite health aims. A good plan would be to consider first the various health habits and principles which could be more clearly comprehended with the aid of physiology. Second, an organization of the subject matter in such a way to accomplish this end and also to inspire a greater interest and confidence in healthy living. Such topics as breathing, respiration, clothing, posture, foods, digestion, exercise, care of the feet, and immunity, natural and acquired, are examples of topics that could be taken up in such a course with profit. Community Health Problems. In the eighth grade and the last year of the junior high school there should be a more direct and a broader study of community health problems than in the previous grades. The boys and girls have reached that age when they begin naturally to take a greater interest in the community. Then, too, many of them during this period will drop out of school and in preparation for complete and active citi- zenship need to consider community problems and the relation of the i]idividual citizen to those problems. In a consideration of these community health problems there should be a study whenever feasible of the community at first hand. For example : They may study the work of the board of health in its different phases and become acquainted with the ways in which it takes care of their personal health. The study of the milk supply is of fundamental importance everywhere. This gives an opportunity 91 HEALTH TEACJHING. not only to study about the character of a good milk supply and the injurious effect of a bad supply, but also to visit some of the near-by dairies. This first-hand study of the milk problem in some cases may be extended even further by making a survey to find out how much milk was consumed per capita. This would lead naturally to the question as to how much milk ought to be consumed and the general value of milk in the diet. Different Types of School Work. One result of the study of concrete health problems in the com- munity is the report in oral or written language lessons. Many con- crete problems of personal hygiene and the health of the community may be helped toward solution by actually getting children to do something to improve their own health and the sanitation of schools and school grounds. Many communities need to have examples pre- sented to them in a concrete form. The written reports of the chil- dren's investigations and recommendations reveal conditions often unknown to their parents. While many of the same kinds of work done in the lower grades can be continued in drawing, writing and dramatizing plays, and making posters, somewhat different types of work are now added to illustrate possible associations of health study with the other subjects of the curriculum. One day each week let the material in language work be health material. Let at least one health problem a month be worked out in drawing, one health poster a month, or scrapbooks for definite assignments. There may also be voluntary work for espe- cially interested and enthusiastic pupils. The frontispiece and the final poster were made in the eighth grade. Compositions and Songs. This is a copy of an eighth-grade composition describing the way in which milk lunches were secured in one district : MILK LUNCHES FOR SCHOOL CHILDREN. By Anna G. Horton. January 25, 1920. To the parents of pupils in our school: We feel that nearly all pupils will receive benefit from eating a light lunch between 10 and half past each school morning. Some children now bring 92 HEALTH TEACHING. lunches, but many others do not who would be better off physically, and in a more alert condition mentally, if they had them also. After careful consideration we have decided to institute lunches for all pupils whose parents care to pay the actual expense which would be involved. A child will be supplied with a glass of milk and two ciackers. The milk costs 15 cents per quart and each quart contains five glasses, so that the cost of five glasses per week w^ill be 15 cents. For 2 cents more we anticipate we can supply each child with two crackers per day. The milk will be brought to the school directly from the farm each morning. As each quart contains five glasses we can supply any number of the children with a glass, provided that the total number of these children is a multiple of five. Parents who wish to take advantage of this arrangement may do so by signing and detaching the lower part of this page and returning it to me at the school.- (Signed) , Principal. I wish my child to have a lunch under the conditions named in the above letter. (Signed) Copies of the above letter were sent to all the parents of pupils in three schools in the district. Before the letters were sent out much time was spent on consider- ing several points. The first question that came into the minds of the principal and his assistants was: What shall the lunches be? Knowing the tremendous food value of milk, it was agreed to have milk as the base of the lunches. It was then remembered that plain milk might be rather distasteful to some ; so it was decided to serve two crackers with each cup of milk. Next came the question as to the kind of milk to be purchased and who the milkman should be. After consulting the board of health it was decided to purchase pasteurized milk. Then came the task of finding a milkman, and this question was answered by one of the large milk corporations in Boston. Paper cups seemed the easiest and most sanitary way of serving, and these the company were only too glad to furnish as an advertisement. Crackers were purchased at wholesale. After all the arrangements had been made the letters were sent hom.e, and the working out of the plan began about the 1st of February. As was promised in the letters, the milk is delivered directly from the farms each morning and arrives at the school building between 8.30 and 9 a. m. HEALTH TEACHIIiJ-G. It is then delivered at the different rooms by two boys under the supervision of a teacher. At recess the children taking the milk take seats on one side of the room. In the Tapper grades the older girls do practically all of the serving. Two girls are assigned to the tasks of shaking, cleaning, and opening the bottles. A third girl prepares the crackers for serving by placing them in a basket and passing up and down the aisles, stopping at each desk, where the consumers take them, During this same period of time a fourth girl is passing the paper cups, which are sent in large pasteboard cartons. When everything is in readiness the milk is poured and it is drunk by the pupils. Every possible precaution is taken to do everything in the best and most sanitary way. The proofs of success are many and varied, but the most important is the decided gain in weight, some children having gained from 5 to 8 pounds during the month of February. In the district covered there are about 650 quarts of milk consumed per week, and it is hoped that the amount will increase as time goes on. Good Health Language Work. Good health language work has been done in Grade VII on the fol- lowing topics suggested by pupils. Some papers were prepared as directions for younger children. What I am doing this summer to gain better health. The good health habits I learned last year at school. Why are we trying to form good health habits? Why I should take good care of my teeth. Why should we swat the fly? Foods that are good for us. Our rules of the health game. The proper way to brush your teeth. Why should I play out of doors every day? What must I do to gain weight? My favorite out-of-door game. How to play it. Why should you try to sit and stand correctly? Write the names of all the vegetables and fruits you have learned to like. Suggested Topics for Language for Grades VIII and IX. Suggested topics for language for Grades VIII and IX are : What this school is doing to exterminate flies. How we earned the money to buy screens for our schoolhouse windows. The value of clean milk, and how it may be produced. 94 HEALTH TEACHING. Ideal health conditions on a farm. Danger from rats, and how we may get rid of them. Why we should sleep with our windows open. Some good health habits, and how they may be formed. How I have improved in health through the practice of the Rules of the Game. The value of clean hands. What our school has done to make the schoolhouse and grounds a better place in which to live. Why I keep my teeth clean. One day's experiment in cheerfulness. Songs. These songs are typical of many of the songs that are being composed and sung by many children throughout the country. OUR HEALTH CAMPAIGN. (Tune — The Loug, Long Trail.) Oh, the health campaign is with us, And we must strive to see it through, So it's eat and eat and eat some more For me and you ; We must always keep on caring For our bodies strong and true, For we mean to show our country What the boys and girls can do. Oh, the health campaign's not easy, As some of us may think, For there's milk and milk and then more milk For us to drink ; We must grow up strong and wealthy. Do our parts in being healthy, For we mean to show our country What the boys and girls can do. KEEP THE GOOD WOEK GOING. (Tune — Keep the Home Fires Burning.) Keep the good work going, While we tall are growing. Though the sun has not gone down, We go to bed. There's a body growing. Seeds of joy we're sowing. Keep the good work going on Till we grow up. 95 HEALTH TEACHING. (Tune — Smiles.) There are foods that make us happy, There are foods that make us blue, There are foods that steal away the rosebuds, As the sunbeams steal away the dew. There are foods that have a hidden magic, That the eyes of God alone may see. And the foods that fill my heart with power, Are the foods that God gives to me. Manual Training. Courses in manual training may be utilized in making hygienic de- vices, such as fireless cookers, iceless refrigerators, flytraps, fly swat- ters, paper drinking cups, rat traps, drainage trough for pump, window boards, and play apparatus. Many of such devices can be used in schools themselves, especially in rural schools, and many of the children may take home what they have made or continue their work there. In many, parent-teacher association's meetings there have been most effective exhibits of hygienic apparatus. Cooking. On previous pages (p. 25) reference has been made to the desira- bility of domestic science courses, preferably "food courses," for both boys and girls and the general content of such courses. This course, planned along the new lines in health work, has been successful in interesting the girls in improving their own physical condition and helping them to a sense of responsibility for the under- weight children in their families concerning whom they make a re- port each month. PLAN FOR ONE-HALF YEAR IN COOKING FOR SEVENTH GRADE. A study of food that is good for children. For breakfasts: Cocoa. Milk makes muscle, bone, and gives vitamines for growth. Drink 1 pint of milk every day, etc. 96 HEALTH TEACHII^G. Toast. Cereals. (Oatmeal and Wheatena.) Eat some cooked cereal every morning. It makes you warm and gives you energy to play hard and work hard. Cereals should be cooked a long time — three to four hours in a double boiler, or better — overnight. Eggs. (Soft and hard cooked, dropped, scrambled.) Eggs, like milk, make muscle, bone, and give vitamines. Eggs also contain iron for healthy red blood. Eggs should always be cooked slowdy. Fried eggs aro not good for children. Creamed Codfish and Creamed Beef. Eggs are expensive ; so we can some- times heat " left overs " or codfish or chipped beef in white sauce. White sauce is made of m'ilk so it will give us what? Apple Sauce, Prunes. The inside of your body should be kept clean as the outside. It is not clean inside if it is clogged up with waste. To keep it clean you should have a bowel movement every day. Do not take " pills," but eat some fruit every day. Fruits contain cellulose, min- eral salts, and acid, which make them good regulators. Breakfast for two or four, including their teacher. Each girl prepared one thing. Some did the buying, some the serving. For cUnners: Milk Soups. (Tomato Bisque, Spinach Soup.) Review of white sauce and food value of milk. Way of using vegetable water (in which mineral salts are lost if water is not used) and small amounts of left-over vegetables. Potatoes. (Mashed, riced, boiled, baked.) A starchy vegetable, therefore giving heat and energy. Mineral salts close under skin of the potato. To retain mineral, cook with skins on. Cook in boiling salted water, covered. After draining off M^ater when done, shake over gas to drive off steam. Vegetables. (Spinach, carrots, onions.) Spinach and carrots give much iron. Most things strongly built were built with some iron. You need to be strongly built. You need iron. Spinach and carrots will give it to you. Spinach, a leafy vegetable, will also give you vitamines. Meat Loaf. Meat, like milk, is a builder, but it is not nearly so good and it costs a lot more. Eat less meat. Drink more milk. Desserts. (Baked custard, junket with soft custard sauce, chocolate bread pudding, brown sugar tapioca. ) Egg plus milk — Custards 1 Milk-Junket JBuilding foods. Bread, plus sugar and cocoa — pudding Tapioca (starch plus sugar) -tapioca puddinr ^^^^* '^^'^ ^"^^^^' ^^^'^• In choosing your dessert you must look over your meals and see what the foods you have planned give. If you have many that give heat and energy, choose a building dessert. If you have mostly regulators and builders in the first parts of your meal, choose a heartier heat and energj'-giving dessert. Dinner served to teachers and gues-.t or pupil as breakfast was served. 44807°— 21 7 97 HEALTH TEACHING. For Suppers: Spaghetti and Macaroni (baked witli cheese or baked with tomato.) Review of method of adding cereal to boiling salted water. Review of white sauce. Food value like cereals — but lacking mineral salts. Made from wheat. Salads. ( Potato, vegetable, very ripe banana and nut ; boiled salad dressing. ) Salads are cool and inviting in summer, and if made of the right foods give us, though cold, the heat and energy and building foods we must have in summer if we are going on gaining. Oftentimes, if these things were hot, we would not eat them. We must eat in summer or we shall lose. Gingerbread. Gives energy and heat because it is made of flour, and it also contains molasses, which is a good regulator. Sugar Cookies. Extras: Milk Sherbet. Made from milk with just lemon juice and sugar added. Another way to get in your milk, even if you do not like to drink it. Candies. ( Stuffed dates, chocolate-dipped nuts and raisins, puffed-rice candy. ) (Taught at Christmas.) Candy takes away your appetite for good better-balanced food if you eat between meals. Eat it after meals. Home-made candy is best. Picnic. (Boys of room invited.) Stuffed egg, date and peanut-butter sand- wiches, prune and cream cheese sandwiches (with graham bread), lettuce sandwiches (boiled dressing); sugar cookies; milk sherbet; fruit (not prepared but brought by each child). SUGGESTED FIVE-MINUTE TALKS. 1. Why are you being weighed? 2. What makes some children underweight? Why are some children pale? 3. What makes some children overweight? 4. Teeth. 5. Rest — Sleep. 6. Exercise. 7. Food — kinds — value. 8. Growth of building material — Milk. 9. Regulators — Leafy vegetables. 10. Buying — Planning meals. 11. Laying table — Serving. (Many others are possible.) Note. — In this course v^'e are trying to teach the children how to live and to make the work in cooking contribute to health, growth, and right living conditions. Other combinations of foods that are good for children are taught during the first half of the eighth year. They prepare a whole meal each lesson, made up of the kinds of foods children should eat to 98 HEALTH TEACHING. become stronger and more beautiful. Other health habits are em- phasized as they are needed. Some other ways in which health material may be used to vitalize the formal subjects of the curriculum in the upper grades are sug- gested by one of the fellowship contestants, as follows: Pupils in an eiglith grade arithmetic class were led to discover that by their absences on account of sick headaches, billions attacks, and other avoidable disorders they were not only having to pay the doctor and druggist, but were reducing the apportionment of school funds, based in that State on the number of days attended. Food bills and receipts were made and market reports were used as the basis of many interesting problems, one of which was the making out of an order for a well-balanced picnic lunch. In this way foods, as well as their prices, were considered. In English classes the children made cookbooks for their mothers, in which they wrote the model recipes previously discussed and tried out in the domestic science classes. Covers for these were designed and made in the drawing classes. Instead of the usual letter-w^riting practice, letters were written to Colgate's for samples of their material and to the Superintendent of Documents at Washington for Government health bulletins, information on flies, fruits, and vegetables, which they later distributed to their parents. A regular correspondence was kept up with children in schools in the Philip- pine Islands and other States in order to find out what they w^ere doing along health and civic lines. The children also wrote to their little friends in the near-by tuberculosis sanitarium and learned from them how they were by health habits growing well again. Advertisements of toothbrushes, soap, out-door sleeping equipment, nutri- tious foods — in fact, everything the children might choose as having to do with health were brought in, exhibited, and studied, and original advertisements written in the English classes and illustrated by drawings. Many of these con- tained comparative food values and prices worked out in the arithmetic classes. The plan, charter, and ordinances of the miniature city government put in operation in the civics classes were w^orked out in the English classes. It provided for a mayor, board of aldermen, board of health, street commissioner, etc. It was the duty of the commissioners to see that citizens kept aisles, blackboards, halls, and desks clean ; while a joint committee from the different grades supervised the cleaning of park and playground, drafting for service, so that each citizen did his bit throughout the term. At stated intervals the mayor sent out a proclamation for Clean Up Day, the posters and publicity for which were worked out in the English and drawing classes. It was the duty of the board of health to look after the weighing and measuring and daily inspection of children, to record findings on the Health Crusade Chart, and report all cases of absence to the teacher, who, as senior health adviser, then called upon the patient at his home. At regular intervals the garbage collector brought into the classes the re- mains of school lunches found in the garbage cans. These furnished a basis 99 HEALTH TEACHING. for lessons in food values as well as in economy, matters of great concern during the war, and in which we should all be interested at any time. The food was weighed and measured before the pupils. Enough scraps were found in one can in one day to make three loaves and a half of bread, as well as pickles of all of the 57 varieties, and quantities of meat, jam, hard boiled eggs, and as hard-baked biscuit. This led to the interesting of the children in more wholesome and economic lunches, and before long the garbage collector complained that his office had become a sinecure. The parents were also interested, though not always sympathetic, and later helped through their association to institute a plan for furnishing warm lunches. In studying the growth and effects of civilization in the history classes, the effects upon health of the change from the open-air, active lives of the pioneers to the present office and factory life of so many workers was particularly noted, while in the lower grades these same facts w^ere noticed in the lives of such heroes as Hiawatha and Daniel Boone. Modern ideas of sanitation and methods of preventing and combating disease w^ere also studied as offsets to the health disadvantages of our present-day civilization. A health display and program was made a part of an exhibition of vegetables grown by the children themselves. Clo^vns bearing appropriate placards made things merry for grown-ups as well as children. An extremely fat clown bore a placard which read, " Eat less." One sturdy fellow bearing the placard, " I was raised on milk. What are you?" went hand-in-hand with the smallest boy In the class, who for the sake of the cause consented to have his placard say, " I was raised on coffee." In one corner two 6-months' old pigs donated by the teacher and an inter- ested friend still further demonstrated the value of milk as food, one having been fed on milk and the other on garbage. The clown in charge explained how each had been fed and pointed to a sign above their pen, '* Which pig do YOU want to be?" The doors to the various classrooms were marked Dr. Sunshine; Dr. Fresh Air ; Dr. Exercise ; Dr. Good Food, and Dr. Rest. " Consultations Free from Dawn until Dark " was the legend on each door. In a little dark room at the end of the same hall was the office of Dr. Bad Habits and Dr. Grouch, who attempted to undermine the influence of the other physicians. In each office a child appropriately dressed distributed health bulletins and talked to the visitors on his particular specialty. These children were chosen by members of the class in an open competition based on three points : Best written ideas for carrying out the exhibit, best 4-minute speech for the character to make, and best acting of the part. In the hall where the garden products were exhibited were charts and posters made by the children featuring the general subject of malnutrition and how to correct it. On a table near by was an exhibit of foods in hundred calorie portions, with their milk equivalents and the prices, which were changed from day to day in keeping with the market report which the children secured from the merchants of the town. In order that the girls might share in the exhibit, since the prevailing senti- ment against women doctors had caused the boys to be chosen for these roles, 100 HEALTH TEACHIITG. model meals were displayed at another table by girls dressed as cooks and v/aitresses. Recipes, such as proper method of cooking oatmeal and meat sub- stitutes, were also distributed. The younger girls prepared dolls properly dressed for the different seasons. Samples of good and bad shoes were pre- ?:ented, and literature and pictures from the National Young Women's Christian Association showing the effects of Improper shoes were explained by another interested pupil. In the afternoons demonstrations in weighing and measuring of the children were given. The gain since* the last monthly weighing rather than the actual weight was emphasized as an index of the child's general condition. It was shown that as many undernourished children come from the country districts as from the town, probably due to the fact that although they have the much- needed sunshine and fresh air, milk, butter, and eggs, they do not always use these foods or enough of them to nourish their bodies properly. Health Standards for Elementary Schools. Every pupil on leaving the elementary school should be as carefully trained in the fundamental habits of health as in the three R's. Without the first, the others are of little value. The real test of health education in the schools is in the health of the children. If there were excellent classroom teaching of health from the kindergarten to the high school, and this were properly supported b}^ coordinated activities of school physician, school nurse, parents, teachers, and all others playing a part in the training of children, what ought we to expect? This is difficult to say, because the experiment has never been tried consecutively for eight or nine years with the same children. Some day the time will come when the great majority of children, possibly 80 or 90 per cent of them, will reach a standard something like this : All children well nourished, none more than 10 per cent below the required standard of weight according to height and age. Habits of personal cleanliness established. Bodily resistance. Freedom from physical defects secured. Good sitting, standing, and walking posture maintained. All teeth kept clean. Permanent teeth all present and in good condition. Daily recreation in the open air. Habit of daily evacuation of the bowels. Practical health knowledge that works. A sense of buoyant physical well-being. Partnership in the solution of school, home, and community problems in health. 101 HEALTH TEACHING. This goal may seem Utopian, but it is just as practicable and possible as it is to apply the scientific rules of agriculture and grow 125 bushels of corn from an acre of land that formerly produced only 40 bushels. A few have dabbled with the health education of chil- dren, but they have done very little along the lines of a coordinated and humanly scientific program for the health education of the school child, Utopian as our goal may seem, many practical people have the vision and are dedicating their lives to its realization. 102 HEALTH TEACHING. BIBLIOGRAPHY. REFERENCE BOOKS FOR TEACHERS. rpHE teacher who wishes to achieve a marked success in her pro- -■- fession will form the habit of reading the latest and best books bearing on her work. The teacher who has access to a large city librar}^ during the year will be able to read many desirable books. Such an opportunity is, however, lacking to many teachers, for few school boards as yet seem disposed to buy such books. The teacher who wishes to keep abreast of the best thought in regard to health will plan to invest money for a few professional books each year. One of these should be a good book on practical health problems. Any of the following books will prove useful : Audress, J. Mace. Teaching Hygiene in the Grades. Boston, Houghton Miff- lin Co. p. 176. A brief practical presentation of the teacher's problems and suggestions for their solution. Health Education in the Rural Schools. Boston, Houghton Mifflin Co. p. 321. Newer aspects of health teaching for the ruml school-teacher. Psychology of health habits, projects, methods, devices, etc. Ayres, Williams, Wood. Healthful Schools, Boston, Houghton Mifflin Co. A book on the hygiene and sanitation of the school plant. Bancroft, Jessie H. The Posture of school children. New York, The Macmillan Co. p. 322. Games for the Playground, Home, School, and Gymnasium. New York., The Macmillan Co. p. 455. Brewer, Isaac Williams. Rural Hygiene. Philadelphia, J. B. Lippincott Co. p. 227. An interesting treatment of the health problems of the country. Curtis, Henry S. Play and Recreation for the Open Country. Boston, Ginn & Co. p. 265. Illus. Special consideration of the problems of rural recreation. One part devoted to the play of the rural school. Excellent. Dress! ar, Fletcher B. School Hygiene. New York, The Macmillan Co. p. 309. Fisher a7ul Fisher. How to Live. New York, Funk & Wagnals. p. 345. 103 HEALTH TEACHIl^G. Gillett, Lucy H. Food Primer for the Home. Bureau of Food Supply. New York, Association for Improving the Condition of tlie Poor. A book containing helpful prescriptions for the health needs of the children. Diet for the School Child. Washington, D. C, Superintendent of Documents. Gulick, Luther H. The Efficient Life. New York, Doubleday, Page & Co. p. 195. Hough and Sedgwick. The Human Mechanism. Boston, Ginn & Co. p. 564. Hutchinson. Woods. Preventable Diseases. Boston, Houghton Mifflin Co. p. 442. Keen, W. W. Medical Research and Human Welfare. Boston, Houghton Mifflin Co. p. 160. An account of the achievements of preventive medicine in the last 50 j^ears. Con- tains much material which the teacher could use. Rapeer, L. W., ed. Educational Hygiene. New York, Scribner. p. 650. A contribution to the hygiene of the school by vai-ious experts. Terman, Lewis M. The Hygiene of the School Child. Boston, Houghton Mifflin Co. p. 417. Latest information on the health of the school child. ~ - Health Work In the Schools. Boston, Houghton Mifflin Co. p. 321. Contains helpful matter for the grade teacher. Walters, Francis M. The Principles of Health Control. Boston, D. C. Heath & Co. p. 476. Differs from usual textbooks in hygiene in emphasizing corrective work. Walton, George Lincoln. Why Worry? Philadelphia, J. B. Lippincott Co. p. 259. A popular and interesting treatment of a bad habit. In addition to the above books every teacher will find the pamphlets on health education issued by the Division of Hygiene of the United States Bureau of Education valuable. Many of these are free; the others may be ordered from the Superintendent of Public Docu- ments, Washington, D. C, at a nominal price. The Child Health Organization, 3t0 Seventh Avenue, New York, is a good source of health material for children and teachers. Other helpful health literature for children and teachers can be secured from the following associations: Metropolitan Life Insurance Co., New York City. The International Harvester Co., Chicago. 104 HEALTH TEACHING. The Aiiiericau Socijil Hygiene Association, 370 Seventh Avenue, New York City. The American Medical Association, Chicago. Boston Association for the Relief and Control of Tuberculosis, 4 Joy Street, Boston. Health Education League, 8 Beacon Street, Boston. Playground and Recreation Association of America, Madison Avenue, New York City. Bureau of Educational Experiments, 16 West Eighth Street, New York City. National Committee for the Prevention of Blindness, 130 East Twenty-second Street, New York City. Modern Health Crusade, Antituberculosis Association, New York City. Nutrition Clinics for Delicate Children, Boston, Mass. SUPPLEMENTARY READING FOR CHILDREN. Andress, J. Mace and Annie T. Rosy Cheeks and Strong Heart. New York, Child Health Organization of America. Bussey, George O. Manual of Personal Hygiene. Boston, Ginn & Co. 1917. Presents concisely the fundamental facts tbat children ought to know about hygiene. Suggestive for both teachers and children. Coleman, Walter Moore. The Handbook of the People's Health. New York, The Macmillan Co. p. 807. General hygiene, profusely illustrated, attractive style. Refers to rural hygiene. Griffith, Eleanor Glendower. Cho-Cho and the Health Fairy. New York, Child Health Organization of America. Gulick, Charlotte Tetter. Emergencies. Boston, Ginn & Co. p. 173. Tells just what to do in every ordinary kind of emergency. Hutchinson, Woods. Community Hygiene. Boston, Houghton Mifflin Co. p. 310. Shows how a helpful and cooperative spirit is the mark of good citizenship. The Child's Day. Boston. Houghton Mifflin Co. p. 184. An excellent book on general hygiene for younger children. A Handbook of Health. Boston, Houghton Mifflin Co. p. 348. Jewett, Frances Gulick. Good Health. Boston, Ginn «& Co. p. 174. A book for little children. Kinne and Cooley. Clothing and Health. New York, The Macmillan Co. Food and Health. New York, The Macmillan Co. The Home and the Family. New York, The IMacmillan Co. A series of beoks on home making. Morris, Josephine. Household Science and Arts. New York, American Book Co. p. 248. A brief, practical book on domestic science. O'Shea and Kellogg. Health Habits. New York, The Macmillan Co. p. 213. A simple and direct presentation of the need of health habits and a detailed dis- cussion of a large number of habits. 105 HEALTH TEACHIXG. Peterson, 2Irs. Frederick. Child Health Alphabet. New York, Child Health Organization of America. Rhymes of Cho-Cho's Grandma. Xew York, Child Health Organiza- tion of America. Pmdden. T. Mitchell. Drinking Water and Ice Supplies. New York, G. P. Putnam's sons. p. 111. Illus. Tells of conditions necessary for pure ice. For older children. Ritchie, John W. Primer of Sanitation. Yonkers-on-Hudson, N. Y., World Book Co. p. 216. and CaldweU, J. S. Primer of Hygiene. Yonkers-on Hudson. 2s. Y., World Book Co. p. 200. Designed to teacli the lower-grade pupil what he himself can do to keep his body in health. Winslow, C. E. A. Healthy Living. Xe^Y York, Chas. E. Merrill Co. A textbook for older children. 106 HEALTH TEACHING. ^ ^^F^^' 107 O LIBRARY OF CONGRESS 019 757 383 1 HEALTH EDUCATION SERIES. CLASS-ROOM WEIGHT RECORD. Single copy, 5 cents. Additional copies, 1 cent each. No. 1. WANTED ! TEACHERS TO ENLIST FOR HEALTH SERVICE. Single copy, 5 cents. Additional copies, 1 cent each. No. 2. DIET FOR THE SCHOOL CHILD. Single copy, 5 cents. Additional copies, 2 cents each. No. 3. SUMMER HEALTH AND PLAY SCHOOL. Single copy, 5 cents. Additional copies, 2 cents each. No, 4. TEACHING HEALTH. Single copy, 5 cents. Additional copies, 2 cents each. 5. CHILD HEALTH PROGRAM FOR PARENT-TEACHER AS- SOCIATIONS AND WOMEN'S CLUBS. Single copy, 5 cents. Additional copies, 3 cents each. 6. FURTHER STEPS IN TEACHING HEALTH. Single copy, 5 cents. Additional copies, 3 cents each. 7. THE LUNCH HOUR AT SCHOOL. Single copy, 5 cents. Additional copies, 4 cents each. 8. HEALTH TRAINING FOR TEACHERS. Single copy, 5 cents. Additional copies, 2 cents each. 9. YOUR OPPORTUNITY IN THE SCHOOLS. Single copy, 5 cents. Additional copies, 3 cents each. 10. SUGGESTIONS FOR A PROGRAM FOR HEALTH TEACH- ING IN THE ELEMENTARY SCHOOLS. Single copy, 1^—1 10 cents. Additional copies, ^ggggg/g/^ Q cents each. Single copies will be sent free of charge upon request addressed to the Bureau of Education. Material in quantity may be purchased from the Superintendent of Docu- ments, Government Printing Office, Washington, D. C. Remittance must accompany order. Stamps are not accepted. Posters. — A decorative poster entitled " Health, Strength, Joy," as well as large height and weight posters for boys and girls, may be procured from the Bureau of Education free of charge. No. No. No. No. No. No.